LETTER
Postoperative Hyponatremia in Menstruant Women
Andrew L. Taylor
15 June 1993 | Volume 118 Issue 12 | Pages 984-985
TO THE EDITOR:
The recent article by Ayus and colleagues [1] is a useful reminder about postoperative hyponatremia. However, the authors, who have so vigorously contributed to the decade of discourse about the most appropriate therapy for hyponatremia, do not provide sufficient details of therapy to allow the reader to determine the causes of the poor outcome in their patients. These patients' hyponatremia was detected a mean of 48 hours after surgery. What was happening in the period before the respiratory arrests occurred, sometimes up to 9 days after surgery? It was stated that surviving women were more often treated with hypertonic saline; however, we need to know the changes in their serum sodium levels, compared with those in women who died, often with pontine or cerebral myelinolysis.
Furthermore, is it possible that the better outcome in male patients was because many absorbed hypotonic fluids through the bladder or urethra?
1. Ayus JC, Wheeler JM, Arieff AI. Postoperative hyponatremic encephalopathy in menstruant women. Ann Intern Med. 1992; 117: 891-7.
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