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Original Article
4 (
1
); 24-28
doi:
10.4103/0976-3147.105605

Hyponatremia after aneurysmal subarachnoid hemorrhage: Implications and outcomes

Department of Neurosurgery, Division of Nursing Education, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
Department of Neurosurgery, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
Address for correspondence: Dr. Saramma PP Senior Lecturer in Nursing, Sree Chitra Tirunal Institute for Medical Sciences and Technology Trivandrum - 695 011, Kerala India ins@sctimst.ac.in
Licence
This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Disclaimer:
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher.

Abstract

ABSTRACT

Background: Hyponatremia is the most common electrolyte abnormality seen in patients with aneurysmal SAH. Clinically significant hyponatremia (Serum Sodium <131 mEq/L) which needs treatment, has been redefined recently and there is a paucity of outcome studies based on this. This study aims to identify the mean Serum Sodium (S.Na+) level and its duration among inpatients with SAH and to identify the relationship between hyponatremia and the outcome status of patients undergoing surgery for SAH. Materials and Methods: This outcome study is undertaken in the department of neurosurgery, The Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala. Medical records of all patients with SAH from 1st January to 31st July 2010 were reviewed. Preoperative status was assessed using World Federation of Neurosurgical Societies (WFNS) grading system. Discharge status was calculated using the Glasgow outcome score scale. Results: Fifty nine patients were included in the study and 53 (89.8%) of them have undergone surgical treatment. Hyponatremia was observed in 22 of 59 patients (37%). The mean Sodium level of hyponatremic patients was 126.97 mEq/L for a median duration of two days. Glasgow outcome score was good in 89.8% of patients. We lost two patients, one of whom had hyponatremia and vasospasm. Conclusion: Hyponatremia is significantly associated with poor outcome in patients with SAH. Anticipate hyponatremia in patients with aneurysmal subarachnoid hemorrhage, timely detect and appropriately treat it to improve outcome. It is more common in patients who are more than 50 years old and whose aneurysm is in the anterior communicating artery. Our comprehensive monitoring ensured early detection and efficient surgical and nursing management reduced morbidity and mortality.

Keywords

Aneurysmal subarachnoid hemorrhage
hyponatremia
neurosurgical
outcome

Conflicts of interest

None declared

REFERENCES

  1. , , . Hyponatremia in neurosurgical patients: Clinical guidelines development. Neurosurg. 2009;65:925-35.
    [Google Scholar]
  2. , , , , , , et al. . The incidence and pathophysiology of hyponatraemia after subarachnoid hemorrhage. Clin Endocrinol. 2006;64:250-4.
    [Google Scholar]
  3. , , , , , , . Hyponatremia and cerebrovascular spasm in aneurysmal subarachnoid hemorrhage. Neurol India. 2006;54:273-5.
    [Google Scholar]
  4. , , , , , , et al. . Prognostic significance of hypernatremia and hyponatremia among patients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2002;50:749-55.
    [Google Scholar]
  5. , , , . Mortality after Hospitalization with Mild, Moderate, and Severe Hyponatremia. Am J Med. 2009;122:857-65.
    [Google Scholar]
  6. , , , , , , et al. . A historic cohort study on the survival rate and the correlated risk factors regarding 174 patients with subarachnoid hemorrhage. Neurosurg Quart. 2010;20:136-41.
    [Google Scholar]
  7. , , , , , , et al. . Pathogenesis of hyponatremia following subarachnoid hemorrhage due to ruptured cerebral aneurysm. Surg Neurol. 1996;46:500-7.
    [Google Scholar]
  8. , , , , . Hyponatremia and cerebral infarction in patients with ruptured intracranial aneurysms: Is fluid restriction harmful? Ann Neurol. 1985;17:137-40.
    [Google Scholar]
  9. , . Hyponatraemia in a neurosurgical patient: Syndrome of inappropriate antidiuretic hormone secretion versus cerebral salt wasting. Nephrol Dial Transplant. 2000;15:262-8.
    [Google Scholar]
  10. , , , . Validation study of a central venous pressure-based protocol for the management of neurosurgical patients with hyponatremia and natriuresis. Neurosurgery. 1997;40:312-6.
    [Google Scholar]
  11. , , , , , , et al. . International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet. 2005;366:809-17.
    [Google Scholar]
  12. , , , , , . Prevalence and clinical demographics of cerebral salt wasting in patients with aneurysmal subarachnoid hemorrhage. Pituitary. 2009;12:347-51.
    [Google Scholar]
  13. , . What is the pathogenesis of hyponatremia after subarachnoid hemorrhage? Nat Clin Pract Endocrinol Metab. 2006;2:608-9.
    [Google Scholar]
  14. , , , , , , et al. . A predictive value of hyponatremia for poor outcome and cerebral infarction in high-grade aneurysmal subarachnoid hemorrhage patients. J Neurol Neurosurg Psychiatry. 2011;82:213-7.
    [Google Scholar]

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