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PATHOGENESIS OF POSTOPERATIVE HYPONATRAEMIA FOLLOWING CORRECTION OF SCOLIOSIS IN CHILDREN
Author(s) -
Cowley D. M.,
Pabari M.,
Sinton T. J.,
Johnson S.,
Carroll G.,
Ryan W. E.
Publication year - 1988
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1988.tb06240.x
Subject(s) - medicine , urine sodium , sodium , free water clearance , urine , urine osmolality , aldosterone , hypernatremia , tonicity , scoliosis , anesthesia , saline , hyponatremia , plasma renin activity , urology , surgery , renin–angiotensin system , blood pressure , chemistry , organic chemistry
Eight pediatric patients undergoing major surgery for correction of scoliosis who were treated postoperatively with hypotonic saline and 5% dextrose have been studied. Plasma sodium. renin and aldosterone. and urine volume. sodium and osmolality were measured. These patients had an impaired ability to excrete a sodium‐free water load. In the first 60 h urine volume remained reduced, while in the first 36 h urine sodium remained concurrently high. If the first 36 h post‐operation are considered, the sodium‐free water given was quantitatively retained and the serum sodium at 36 h was significantly correlated with the amount of free water given ( P < 0.01). To minimize postoperative hyponatraemia and the associated shift of water into the brain causing cerebral oedema. it is recoinniended that no more than 50 ml/kg sodium‐free water be given until urine sodium falls and volume increases.