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Japanese

Significance of Plasma Atrial Natriuretic Peptide Measurement During the Management of Hyponatremia in Neurosurgical Patients Yasutaka Kurokawa 1 , Teiji Uede 1 , Osamu Honda 1 , Takaaki Kato 1 , Osamu Honmou 2 1Department of Neurosurgery, Kushiro City General Hospital 2Department of Neurosurgery, Sapporo Medical College Keyword: ADH , atrial natriuretic peptide , hyponatremia , SIADH pp.359-364
Published Date 1992/4/1
DOI https://doi.org/10.11477/mf.1406900324
  • Abstract
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We have examined the total number of admitted cases to clarify the pathogenesis of hyponatremia during the management of neurosurgical patients. We experienced 32 cases of hyponatremia during the past year by measuring the sodium balance and atrial natriuretic peptide (ANP) level. According to these two factors, we divided the cases into three groups.

The first group shows normal ANP levels in spite of hyponatremia. Low administration of the sodium was thought to be the cause in these cases.

The second group shows the elevated ANP levels with a positive sodium balance. Elevated circula-tory volume due to the inadequate level of antidiur-etic hormone and mild heart and/or kidney failures cause these conditions. Water restriction and/or diuresis were effective methods in the management of the cases.

The last group shows the elevated ANP levels with a negative sodium balance. There is a statisti-cally significant negative correlation between sodium balance and the ANP level. Marked natriu-resis due to the elevated ANP causes the decrement of the circulatory volume in these cases. Path-ogenesis of the last group is very important in the management of neurosurgical patients in an acute state, especially in subarachnoid hemorrhage cases. The decrement of the systemic circulatory volume would jeopardize the patient's neurological condi-tion. In this group, water restriction that has been commonly recommended is contraindicated. Satis-factory water and sodium replenishment seems to be the best recommended treatment for this group.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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