Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review
Hyponatremia is a common electrolyte disorder, especially in the frail elderly population. With the increasing number of surgeries in the aging population, hyponatremia is frequently encountered by anesthesiologists and surgeons. Unfortunately, management of hyponatremia is often complex in the eld...
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PAGEPress Publications
2021
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oai:doaj.org-article:16dc9e4f4354481e9cc4de7b710b11722021-11-30T21:41:12ZElderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review10.4081/gc.2021.99112465-11092465-1397https://doaj.org/article/16dc9e4f4354481e9cc4de7b710b11722021-11-01T00:00:00Zhttps://www.pagepressjournals.org/index.php/gc/article/view/9911https://doaj.org/toc/2465-1109https://doaj.org/toc/2465-1397 Hyponatremia is a common electrolyte disorder, especially in the frail elderly population. With the increasing number of surgeries in the aging population, hyponatremia is frequently encountered by anesthesiologists and surgeons. Unfortunately, management of hyponatremia is often complex in the elderly population as it is often multifactorial, and they are physiologically susceptible. While it is well known that preoperative hyponatremia is associated with increased perioperative morbidity and mortality, a lack of recommendations or guidelines adds to the dilemma in managing such cases. The most common cause of chronic hyponatremia in the elderly is the syndrome of inappropriate antidiuretic hormone (SIADH), which can be resistant to conventional treatment. On the other hand, paraneoplastic SIADH leading to hyponatremia is rare, and surgery may be the only option available for its correction. We present a case of a 78- years-gentleman to highlight such a dilemma. He was diagnosed with renal cell carcinoma and had chronic refractory severe hyponatremia despite treatment with fluid restriction, low dose hydrocortisone, tolvaptan, and 3% sodium chloride. Manish KeshwaniHabib Md Reazaul KarimSuresh NagalikarDeepak Kumar BiswalSamarjit DeyPAGEPress PublicationsarticleHyponatremiaelderlyparaneoplastic syndromesyndrome of inappropriate antidiuretic hormone.GeriatricsRC952-954.6ENGeriatric Care, Vol 7, Iss 3 (2021) |
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DOAJ |
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EN |
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Hyponatremia elderly paraneoplastic syndrome syndrome of inappropriate antidiuretic hormone. Geriatrics RC952-954.6 |
| spellingShingle |
Hyponatremia elderly paraneoplastic syndrome syndrome of inappropriate antidiuretic hormone. Geriatrics RC952-954.6 Manish Keshwani Habib Md Reazaul Karim Suresh Nagalikar Deepak Kumar Biswal Samarjit Dey Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review |
| description |
Hyponatremia is a common electrolyte disorder, especially in the frail elderly population. With the increasing number of surgeries in the aging population, hyponatremia is frequently encountered by anesthesiologists and surgeons. Unfortunately, management of hyponatremia is often complex in the elderly population as it is often multifactorial, and they are physiologically susceptible. While it is well known that preoperative hyponatremia is associated with increased perioperative morbidity and mortality, a lack of recommendations or guidelines adds to the dilemma in managing such cases. The most common cause of chronic hyponatremia in the elderly is the syndrome of inappropriate antidiuretic hormone (SIADH), which can be resistant to conventional treatment. On the other hand, paraneoplastic SIADH leading to hyponatremia is rare, and surgery may be the only option available for its correction. We present a case of a 78- years-gentleman to highlight such a dilemma. He was diagnosed with renal cell carcinoma and had chronic refractory severe hyponatremia despite treatment with fluid restriction, low dose hydrocortisone, tolvaptan, and 3% sodium chloride.
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| format |
article |
| author |
Manish Keshwani Habib Md Reazaul Karim Suresh Nagalikar Deepak Kumar Biswal Samarjit Dey |
| author_facet |
Manish Keshwani Habib Md Reazaul Karim Suresh Nagalikar Deepak Kumar Biswal Samarjit Dey |
| author_sort |
Manish Keshwani |
| title |
Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review |
| title_short |
Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review |
| title_full |
Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review |
| title_fullStr |
Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review |
| title_full_unstemmed |
Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review |
| title_sort |
elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review |
| publisher |
PAGEPress Publications |
| publishDate |
2021 |
| url |
https://doaj.org/article/16dc9e4f4354481e9cc4de7b710b1172 |
| work_keys_str_mv |
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