Das gynäkologische „TUR-Syndrom“

Serocki, G.; Hanß, R.; Bauer, Martin; Scholz, Jens; Bein, Berthold

doi:10.1007/s00101-008-1446-3

Cited by 20 publications

(6 citation statements)

References 10 publications

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“…80 mmHg (or 40 inches height of water), can result in rapid intravasation. [34] Measurement of fluid absorption however remains capricious. The absorbed volume of fluid employed for uterine distention depends on the extent of transection of vascular beds, intrauterine distention pressures, duration of the procedure and surgical experience.…”

Section: Discussionmentioning

confidence: 99%

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Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue

2012

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Operative hysteroscopy has emerged as an effective alternative to hysterectomy and has become standard surgical treatment for varied gynaecological conditions like abnormal uterine bleeding and uterine myomas. This procedure requires distention of the uterine cavity for adequate visualization of the operative field. 1.5% glycine is a widely used distention medium because it has good optical properties and is non-conductive. However, the intraoperative absorption of this electrolyte-free fluid can cause hyponatraemia, hypoosmolality, hyperglycinaemia and volume overload, including pulmonary oedema. We report a case of operative hysteroscopy intravascular absorption (OHIA) syndrome, presenting abruptly during hysteroscopic myomectomy, employing 1.5% glycine as the fluid distention medium. Successful management of the case and prevention strategies are discussed.

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Section: Discussionmentioning

confidence: 99%

“…Transurethral Resection of Prostate (TURP) syndrome; hence, the alternate term gynaecological TURP syndrome. [3]…”

Section: Introductionmentioning

confidence: 99%

Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue

2012

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“…At the time of symptoms, a total of 76 liters of irrigant fluids were used in our patient, which clearly exceeds the usually used 4–7 liters. Using the formula proposed by Serocki et al, we calculated a fluid overload of 11 liters [11]. This hypervolemia lead to the laryngeal swelling.…”

Section: Discussionmentioning

confidence: 99%

Life-Threatening Laryngeal Edema and Hyponatremia during Hysteroscopy

Wegmüller

Hug²,

Buenzli³

et al. 2011

Critical Care Research and Practice

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We report on a 43-year-old patient undergoing a hysteroscopic myomectomy. After 80 minutes of operation, the patient developed laryngeal edema, requiring emergency tracheostomy. Hyponatremia (serum sodium 78 mmoL/L) indicated an irrigation fluid absorption. The patient developed shock, acute respiratory distress syndrome, acute renal failure, and diffuse intravascular coagulopathy. Resuscitation including continuous venovenous hemodiafiltration was required. Finally, the patient made a full clinical recovery. Hysteroscopy usually has low risks. However, absorption of the irrigation fluid can result in life-threatening fluid overload and electrolyte disturbances. Accurate fluid balancing and limiting the operation time may prevent these complications.

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“…Outras situações análogas seriam os afogamentos em água doce 25 e as cirurgias endoscópicas, como a histeroscopia, 26 curetagem uterina 27 e a ressecção transuretral da próstata, 28,29 em que pode haver absorção rápida de grande quantidade da água contida nas soluções de irrigação.…”

Section: Quadro 1 Estímulos Para Secreção De Adhunclassified

Hiponatremia: conceitos básicos e abordagem prática

Rocha¹

2011

J. Bras. Nefrol.

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Os autores declaram a inexistência de conflitos de interesse. ResumoHiponatremia é o distúrbio hidroeletrolítico mais comum em pacientes hospitalizados. A presença de hiponatremia está associada a uma série de desfechos desfavoráveis, tais como: necessidade de internamento em unidade de terapia intensiva, hospitalização prolongada e de maior custo, transferência para abrigos e mortalidade. Ainda não está claro se existe relação de causalidade direta ou se a hiponatremia é apenas um marcador de gravidade da doença de base. No entanto, sabe-se que o manejo inadequado de um paciente hiponatrêmico pode causar graves danos neurológicos ou até mesmo a morte. Neste manuscrito, os conceitos básicos sobre a fisiopatologia da hiponatremia serão revisados, seguido de uma abordagem prática sobre sua investigação e tratamento. Palavras-chave: hiponatremia, síndrome de secreção inadequada de HAd, receptores de vasopressina, Cirrose Hepática, Insuficiência Cardíaca. AbstRActHyponatremia is the most common electrolyte imbalance in hospitalized patients. It is associated with several unfavorable endpoints such as: the need for intensive care, longer hospital stay, higher hospitalization costs, discharge to long-term care facilities, and mortality. It is still not clear if there is a direct causal relationship or if hyponatremia is simply a marker of disease severity. Nevertheless, it is quite clear that improper management of a hyponatremic patient may result in severe neurologic damage or death. This paper addresses the basic pathophysiologic concepts about hyponatremia followed by a practical approach to its diagnosis and management.

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Das gynäkologische „TUR-Syndrom“

Cited by 20 publications

References 10 publications

Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue

Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue

Life-Threatening Laryngeal Edema and Hyponatremia during Hysteroscopy

Hiponatremia: conceitos básicos e abordagem prática

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