A method to estimate urinary electrolyte excretion in patients at risk for developing cerebral salt wasting

Carlotti, Ana P. C. P.; Bohn, Desmond; Rutka, James T.; Singh, Sheila K.; Berry, William A.; Sharman, Asheer; Cusimano, Michael D.; Halperin, Mitchell L.

doi:10.3171/jns.2001.95.3.0420

Cited by 32 publications

(17 citation statements)

References 28 publications

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“…30 Urine examination often reveals a negative balance for sodium on one of those initial days in the ICU, typically demonstrating high urinary concentrations of sodium, potassium, and chloride in the setting of hyponatremia. 15 These findings usually provide the basis on which the clinical diagnosis of CSW may be made. 15,30 Nevertheless, a stimulus to excrete sodium and chloride ions, such as expanded extracellular fluid volume, must be ruled out.…”

Section: Traumatic Brain Injurymentioning

confidence: 99%

“…15 These findings usually provide the basis on which the clinical diagnosis of CSW may be made. 15,30 Nevertheless, a stimulus to excrete sodium and chloride ions, such as expanded extracellular fluid volume, must be ruled out. It is difficult to ascertain whether extracellular fluid, or even more importantly, the ECV is contracted on clinical grounds unless changes are quite marked.…”

Section: Traumatic Brain Injurymentioning

confidence: 99%

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Hyponatremia in the neurosurgical patient: diagnosis and management

Cole¹,

Gottfried²,

Liu³

et al. 2004

FOC

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Hyponatremia is frequently encountered in patients who have undergone neurosurgery for intracranial processes. Making an accurate diagnosis between the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and cerebral salt wasting (CSW) in patients in whom hyponatremia develops is important because treatment differs greatly between the conditions. The SIADH is a volume-expanded condition, whereas CSW is a volume-contracted state that involves renal loss of sodium. Treatment for patients with SIADH is fluid restriction and treatment for patients with CSW is generally salt and water replacement. In this review, the authors discuss the differential diagnosis of hyponatremia, distinguish SIADH from CSW, and highlight the diagnosis and management of hyponatremia, which is commonly encountered in patients who have undergone neurosurgery, specifically those with traumatic brain injury, aneurysmal subarachnoid hemorrhage, recent transsphenoidal surgery for pituitary tumors, and postoperative cranial vault reconstruction for craniosynostosis.

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Section: Traumatic Brain Injurymentioning

confidence: 99%

Section: Traumatic Brain Injurymentioning

confidence: 99%

Hyponatremia in the neurosurgical patient: diagnosis and management

Cole¹,

Gottfried²,

Liu³

et al. 2004

FOC

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“…Ellos creen que los pacientes eliminan los líquidos administrados previamente por vía endovenosa durante una reanimación excesiva o excretan fisiológicamente el sodio debido a reducción de los vasos venosos de capacitancia, originada por vasoconstricción inducida por catecolaminas 11,24,25 . Otro autor sugiere que, si no se puede probar si hay diferencias entre la EPS y SIADH, debe darse el mismo tratamiento: sodio.…”

Section: Discussionunclassified

Encefalopatía perdedora de sal en romboencefalitis por listeria

Vega

Matamala

2013

Rev. méd. Chile

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“…In some observational studies CSW has been found more frequently than SIADH. Most of the reports we have found in the literature come from neuroanaesthesia and neurocritical care units, but there is little evidence about its prevalence in non-critical neurology patients 9 .…”

mentioning

confidence: 99%

“…The differential diagnostics of CSW versus syndrome of inappropriate secretion of antidiuretic hormone (SIADH) rests upon distinguishing between hyponatremic hyperhydration -and thus an excess of clear water -(SIADH) and hyponatremic dehydration (CSW) 7,8 . Unlike SIADH management requiring strict fluid restriction and diuretic therapy, the treatment of CSW aims at achieving an adequate fluid balance and substitution of hyponatremia 9 . In some observational studies CSW has been found more frequently than SIADH.…”

mentioning

confidence: 99%

Cerebral Salt Wasting Syndrome in a Patient With Primary CNS Lymphoma

Procházka¹,

Kubová²,

Raida³

et al. 2009

BIOMED PAP

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Background:In patients with severe central nervous system (CNS) diseases, life-threatening hyponatremia results from two main causes: the syndromes of inappropriate secretion of antidiuretic hormone (SIADH) and cerebral salt wasting (CSW). Clinical manifestations of the two conditions may be similar but their pathogeneses are fundamentally diverse. Distinguishing SIADH from CSW is based on the differential diagnoses of dilutional hyponatremia due to an excessive amount of water in the body (SIADH) and depletional hyponatremia caused by extensive natriuresis (CSW). Methods and Results:We report the case of a 48-year-old, previously healthy male with a diffuse large B-cell lymphoma affecting the area of the basal ganglia and the right part of the thalamus and oppressing the third brain ventricle. After admission to the Department of Hemato-oncology, the patient was soporous and laboratory tests revealed severe serum hyponatremia, hypochloremia, hypoosmolality and marked polyuria with normal serum levels of urea, creatinine, glucose and calcium. Urinalysis showed high specific gravity of the urine and extreme wasting of sodium, chloride and kalium ions. Overall fluid balance was negative. After the first chemotherapy cycle, the CT scan confirmed regression of the tumour site. This was accompanied by patient's improved cognition as well as decreased polyuria and urine electrolyte excretion. Eventually, it was concluded that the diagnosis was cerebral salt wasting syndrome.Conclusion: We noted a so far unpublished case of a 48-year-old male with the diagnosis of primary CNS lymphoma (DLBCL) affecting deep structures of the brain and associated with CSW.

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A method to estimate urinary electrolyte excretion in patients at risk for developing cerebral salt wasting

Abstract: Mass balances for Na+ plus K+ and for Cl- can be accurately estimated. These data provide information to support or refute a clinical diagnosis of CSW. The danger of relying on balances for these electrolytes measured within a single day to diagnose CSW is illustrated.

Cited by 32 publications

References 28 publications

Hyponatremia in the neurosurgical patient: diagnosis and management

Hyponatremia in the neurosurgical patient: diagnosis and management

Encefalopatía perdedora de sal en romboencefalitis por listeria

Cerebral Salt Wasting Syndrome in a Patient With Primary CNS Lymphoma

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