Hyponatremia in Postoperative Patients

Efficacy of vaptans for correction of postoperative hyponatremia: A comparison between single intravenous bolus conivaptan vs oral tolvaptan

“…It is common in elderly postoperative patients and the outcome could be catastrophic if there is delay in diagnosis and proper management. [ 2 3 ] Traditionally, hyponatremia is managed with fluid restriction and intravenous administration of 3% hypertonic saline. [ 3 ]…”

Efficacy of oral tolvaptan versus 3% hypertonic saline for correction of hyponatraemia in post-operative patients

“…It is common in post-operative patients who are elderly, and the outcome could be catastrophic if early warnings of hyponatraemia are not recognised on time and not managed effectively. [ 11 12 ] Postoperatively, it has been documented that the average length of hospital stay of hyponatraemic patients is between 1.44 and 9.2 days longer than normal patients with an increased mortality rate of 2.1%–28.1%. [ 13 ] As per our institutional protocol, during major surgeries, electrolytes are monitored at least every 4 h with arterial blood gas analysis.…”

“…The traditional management of post-operative hyponatraemia is fluid restriction and intravenous administration of HTS. [ 12 ] HTS is considered as a safe alternative to mannitol, especially for a long-term use or when multiple doses are needed in post-operative patients. [ 14 ] Acute-onset hyponatraemia (duration of <48 h) requires prompt correction, whereas chronic hyponatraemia should be corrected cautiously as there is a higher risk of development of central pontine myelinolysis following excessive and rapid correction.…”