Causes of hyponatremia

By -

 Hypovolemic hyponatremia:

Renal loss:

  • Diuretics
  • Ketonuria
  • Hypoadrenalism - mineralocorticoid deficiency 
  • Metabolic alkalosis 
  • Renal tubular acidosis
  • Protein-losing nephropathy 

Extrarenal loss:

  • Vomiting 
  • Diarrhoea 
  • Burn 
  • Pancreatitis 
  • Third space loss

Hypervolemia hyponatremia:

  • Congestive cardiac failure 
  • Cirrhosis 
  • Nephrotic syndrome 

Euvolemic hyponatremia:

↓ Plasma osmolarity:

  • SIADH
  • Renal failure 
  • Hypothyroidism 
  • Surgical stress/ Sympathetic stimulation 
  • Glucocorticoid deficiency
  • Drugs
    • ↑ ADH secretion - 
      • Barbiturate 
      • Opioid 
      • Hypoglycemic
      • SSRI
      • Antipsychotic 
      • Carbamazepine 
    • Potentiation of ADH - 
      • Paracetamol
      • NSAIDs
    • ADH analogue - 
      • Oxytocin
      • Vasopressin
      • Desmopressin 

Normal plasma osmolarity:

  • Pseudohyponatremia  


Reference: 
Smith and Aitkenhead's Textbook of Anaesthesia, 7th Edition
Stoelting's Anesthesia and Co-Existing Disease, 7th Edition 

Morgan & Mikhail's Clinical Anesthesiology, 6 Edition 

Comments

Post a Comment

Please share your views and comments in the comment section. Give your opinion if there is anything to update.

Subscribe the channel to get updates regarding regular blog post.

Share the content if you think its appropriate.

Thank you.

Popular posts from this blog

Regulation of Hepatic blood flow

By -
  Blood supply of liver  25% of cardiac output, 1.5 L/ min Blood supply by hepatic artery (1/3 supply, 98% O2 saturation) and hepatic portal vein (2/3 supply, 70 - 85% O2 saturation) The hepatic triad is formed by the branches of the hepatic artery, hepatic portal vein and bile canaliculus which run together  Portal venue and hepatic arteriole join together to form hepatic sinusoid (specialised capillary system) which optimises exchange with hepatocyte  Venous drainage to IVC via right and left hepatic vein  Regulation of hepatic blood flow  Hepatic artery - extrinsic and intrinsic regulation mechanism  Portal vein - extrinsic regulation  mechanism  Intrinsic mechanism:  Myogenic autoregulation 👉🏻 if drop-in hepatic arterial pressure ➡️ flow is maintained by a decrease in hepatic arterial resistance  Hepatic arterial buffer response 👉🏻 if reduction of flow in portal vein ➡️ compensatory decrease in resistance of hepatic artery t...
Read more

Monitoring neuromuscular block

By -
Image
Following stimulation of the relevant nerve. Nerve stimulators must generate a supramaximal stimulus (60–80 mA) to ensure that all the composite nerve fibres are depolarized. Duration 0.1 ms. Negative electrode directly over the nerve. Positive electrode  placed where it cannot affect the muscle in question. Five main patterns of stimulation Single twitch stimulation Simplest form Requires a baseline twitch height Reduction in twitch height observed until 75% of NMJ receptors have been occupied by muscle relaxant  Only a small number of receptors are required to generate a summated mini end-plate potential, which triggers an action potential Partial NMJ block with depolarizing muscle relaxants (DMRs) and non-depolarizing muscle relaxants (NDMRs) reduce the height of single twitch stimulation. Tetanic stimulation Individual stimuli are applied at a frequency >30 Hz Twitches observed in the muscle become fused into a sustained muscle contraction – tetany Most stimulators deli...
Read more