https://doi.org/10.4081/gc.2021.9911
Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review
Submitted: 15 June 2021
Accepted: 8 November 2021
Published: 30 November 2021
Accepted: 8 November 2021
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Hyponatremia is a common electrolyte disorder, especially in the frail elderly population. With the increasing number of surgeries in the aging population, hyponatremia is frequently encountered by anesthesiologists and surgeons. Unfortunately, management of hyponatremia is often complex in the elderly population as it is often multifactorial, and they are physiologically susceptible. While it is well known that preoperative hyponatremia is associated with increased perioperative morbidity and mortality, a lack of recommendations or guidelines adds to the dilemma in managing such cases. The most common cause of chronic hyponatremia in the elderly is the syndrome of inappropriate antidiuretic hormone (SIADH), which can be resistant to conventional treatment. On the other hand, paraneoplastic SIADH leading to hyponatremia is rare, and surgery may be the only option available for its correction. We present a case of a 78- years-gentleman to highlight such a dilemma. He was diagnosed with renal cell carcinoma and had chronic refractory severe hyponatremia despite treatment with fluid restriction, low dose hydrocortisone, tolvaptan, and 3% sodium chloride.
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How to Cite
Keshwani, M., Karim, H. M. R., Nagalikar, S., Kumar Biswal, D. ., & Dey, S. (2021). Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review. Geriatric Care, 7(3). https://doi.org/10.4081/gc.2021.9911
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