Encephalopathy from Hyponatremia

Excerpt

To the Editors: According to the report documenting the development of severe hyponatremia in healthy young women after unremarkable elective surgical procedures (1), hyponatremia was noted within 32 hours of the procedure and was further complicated by central diabetes mellitus and insipidus; all patients either died or suffered permanent brain damage. The hyponatremia was attributed to inappropriate secretion of antidiuretic hormone combined with excessive postoperative administration of hypotonic fluid (2) and loss of isotonic fluid (as emesis or nasogastric suction). General anesthesia depresses urinary flow rate, glomerular filtration rate, renal blood flow, and excretion of electrolytes (3). The consistent and