RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1730043
High Incidence of Hyponatremia in Patients Operated for Nonsellar/Suprasellar Supratentorial Tumors—A Prospective Observational Study
![](https://www.thieme-connect.de/media/10.1055-s-00037681/202103/lookinside/thumbnails/10-1055-s-0041-1730043-1.jpg)
Abstract
Background The incidence of hyponatremia is high in supratentorial tumors. However, most studies of supratentorial tumors have included patients with sellar/suprasellar tumors. It is common knowledge that sellar tumors have higher incidence and severity of hyponatremia. Incidence of hyponatremia is not known if we exclude sellar/suprasellar tumors. Therefore, this study was designed to evaluate the incidence of hyponatremia in supratentorial tumors after excluding sellar/suprasellar tumors.
Methods After institutional ethics committee approval and written informed consent, adult patients with supratentorial tumors (nonsellar/suprasellar) were recruited, and data were collected prospectively. In all patients, serum electrolytes were measured every 2 to 3 days. Hyponatremia was defined as serum sodium of <135 mEq/L. All the patients were followed up till death or discharge from the hospital.
Results A total of 61 patients’ data were analyzed. There were 31 male and 30 female patients with an average age of 44 years. There were 23 meningiomas, 36 gliomas, and 2 other tumors. Forty patients (66%) developed hyponatremia during hospital stay. There were 29 mild cases (serum sodium 131–134 mEq/L), 7 were moderate (serum sodium 126–130 mEq/L), and 4 were severe (serum sodium <126 mEq/L). Three hyponatremic meningioma patients died, of which two had mild hyponatremia and one had severe hyponatremia. Duration of hospital stay was longer in hyponatremic patients.
Conclusion The incidence of hyponatremia is high in supratentorial tumor patients after excluding sellar/suprasellar lesions. In the majority of patients, the disturbance is mild. Hyponatremic patients has a longer hospital stay and higher mortality.
Publikationsverlauf
Artikel online veröffentlicht:
03. August 2021
© 2021. Indian Society of Neuroanaesthesiology and Critical Care. 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/).
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Arieff AI. Management of hyponatraemia. BMJ 1993; 307 (6899) 305-308
- 2 Fried LF, Palevsky PM. Hyponatremia and hypernatremia. Med Clin North Am 1997; 81 (03) 585-609
- 3 Reeder RF, Harbaugh RE. Administration of intravenous urea and normal saline for the treatment of hyponatremia in neurosurgical patients. J Neurosurg 1989; 70 (02) 201-206
- 4 Arieff AI, Llach F, Massry SG. Neurological manifestations and morbidity of hyponatremia: correlation with brain water and electrolytes. Medicine (Baltimore) 1976; 55 (02) 121-129
- 5 Peri A. Morbidity and mortality of hyponatremia. Front Horm Res 2019; 52: 36-48
- 6 Lee CT, Guo HR, Chen JB. Hyponatremia in the emergency department. Am J Emerg Med 2000; 18 (03) 264-268
- 7 Harrigan MR. Cerebral salt wasting syndrome: a review. Neurosurgery 1996; 38 (01) 152-160
- 8 Hasan D, Wijdicks EF, Vermeulen M. Hyponatremia is associated with cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage. Ann Neurol 1990; 27 (01) 106-108
- 9 Patwari AK, Singh BS, Manorama DE. Inappropriate secretion of antidiuretic hormone in acute bacterial meningitis. Ann Trop Paediatr 1995; 15 (02) 179-183
- 10 Dholke H, Campos A, Reddy CN, Panigrahi MK. Cerebral salt wasting syndrome. J Neuroanaesth Crit Care 2016; 3: 205-210
- 11 Rajagopal R, Swaminathan G, Nair S, Joseph M. Hyponatremia in traumatic brain injury: a practical management protocol. World Neurosurg 2017; 108: 529-533
- 12 Cui H, He G, Yang S. et al Inappropriate antidiuretic hormone secretion and cerebral salt-wasting syndromes in neurological patients. Front Neurosci 2019; 13: 1170
- 13 Madden JR, Dobyns E, Handler M, Foreman NK. Experience with electrolyte levels after craniotomy for pediatric brain tumors. J Pediatr Oncol Nurs 2010; 27 (01) 21-23
- 14 Kristof RA, Rother M, Neuloh G, Klingmüller D. Incidence, clinical manifestations, and course of water and electrolyte metabolism disturbances following transsphenoidal pituitary adenoma surgery: a prospective observational study. J Neurosurg 2009; 111 (03) 555-562
- 15 Hannon MJ, Thompson CJ. Hyponatremia in neurosurgical patients. Front Horm Res 2019; 52: 143-160
- 16 Belzer JS, Williams CN, Riva-Cambrin J, Presson AP, Bratton SL. Timing, duration, and severity of hyponatremia following pediatric brain tumor surgery. Pediatr Crit Care Med 2014; 15 (05) 456-463
- 17 Sherlock M, O’Sullivan E, Agha A. et al Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients. Postgrad Med J 2009; 85 (1002) 171-175
- 18 Kiran Z, Sheikh A, Momin SN. et al Sodium and water imbalance after sellar, suprasellar, and parasellar surgery. Endocr Pract 2017; 23 (03) 309-317
- 19 Cote DJ, Alzarea A, Acosta MA. et al Predictors and rates of delayed symptomatic hyponatremia after transsphenoidal surgery: a systematic review. World Neurosurg 2016; 88: 1-6
- 20 Kao L, Al-Lawati Z, Vavao J, Steinberg GK, Katznelson L. Prevalence and clinical demographics of cerebral salt wasting in patients with aneurysmal subarachnoid hemorrhage. Pituitary 2009; 12 (04) 347-351
- 21 Barber SM, Liebelt BD, Baskin DS. Incidence, etiology and outcomes of hyponatremia after transsphenoidal surgery: experience with 344 consecutive patients at a single tertiary center. J Clin Med 2014; 3 (04) 1199-1219