INAPPROPRIATE SECRETION OF ANTIDIURETIC-HORMONE IN POSTOPERATIVE SCOLIOSIS PATIENTS - THE ROLE OF FLUID MANAGEMENT

Study Design, The present study examined the hypothesis that hypotonic saline therapy before surgery was a major factor in the development o f the syndrome of inappropriate antidiuretic hormone secretion. Object ives, The influence of fluid therapy and its relationship to the syndr ome of inappropriate antidiuretic hormone secretion was studied by mea suring patient electrolyte and osmolar responses at given times after surgery. Summary of Background Data, Mild renal dysfunction and increa sed plasma antidiuretic hormone occurs after surgery. Occurrence of th e syndrome of inappropriate secretion of antidiuretic hormone after sp ine surgery is rare. The development of the syndrome of inappropriate secretion hormone after surgery may be related to hypotonic fluid repl acement during and after surgery. Methods, Twelve patients undergoing surgery for correction of idiopathic scoliosis were assigned randomly to two groups. The control group (five patients) was given isotonic sa line, and the trial group (seven patients) was given hypotonic saline. Results, The trial group developed syndrome of inappropriate antidiur etic hormone secretion with a significant decrease in serum sodium and osmolarity. The control group did not develop syndrome of inappropria te antidiuretic hormone secretion. Conclusions, Hypotonic saline thera py predisposes to the development of syndrome of inappropriate antidiu retic hormone secretion, whereas isotonic saline protects patients fro m syndrome of inappropriate antidiuretic hormone secretion when underg oing surgery for scoliosis.