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PubMed1966

Postoperative care.

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Blood Circulation↗
PubMed1984

Assessment of SIADH in psychosis with a water-loading test: case report.

A man taking haloperidol presented with psychosis, polydipsia, and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A water-loading test indicated that haloperidol did not cause the SIADH. In patients taking haloperidol or other neuroleptics associated with SIADH who develop psychosis, polydipsia, and complications of SIADH such as hyponatremia, water loading may be helpful in adjusting psychotropic medications so as to control psychosis while avoiding the complications of hyponatremia.

Adult↗
PubMed1976

[Disturbances of Free Water and Electrolyte Metabolism: Three large groups are differentiated].

1. Disturbances of free water which are related to the whole body water and are always coupled with changes in the osmolality of the internal environment and also of the interior of the cells. 2. Isotonic changes of the volume of the extracellular fluid- edema or extracellular dehydration. The latter is always coupled with a hypovolemia and with a danger to the circulation which may end in shock. There is also a cumulative loss of potassium as a result of the dehydration reaction. 3. Disturbances of the intracellular water metabolism which are associated with disturbances of the potassium metabolism. These may have consequences for the function of striated and smooth muscles, for the function of the nerves and various enzyme systems.

Adult↗
PubMed1993

Symptomatic hyponatremia during prolonged exercise in heat.

Although hyponatremia (HN) has been reported among endurance athletes, its etiology often remains uncertain and of great interest to clinicians and physiologists. This case report presents physiologic evidence regarding the etiology and development of HN during exercise in the heat. A 21-yr-old male volunteer (K.G.) unexpectedly experienced symptomatic HN during a research investigation that involved controlled sodium (Na+) intake (137 mEq Na+.d-1 for 7d) and exercise-heat acclimation (41 degrees C; 30 min.h-1, 8 h.d-1 for 10 d). Fluid balance, physiologic variables, and hematologic/hormone data were measured before and after the HN episode, with similar measurements recorded for nine unaffected volunteers. The results indicated: 1) HN was verified in K.G. (plasma Na+ < 130 mEq.l-1) after only 4 h of mild, intermittent exercise in heat; 2) K.G.'s heart rate, rectal temperature, blood pressure, and Na+ losses in sweat and urine were < or = control subjects at all times; 3) between hours 4-7, an inappropriately large release of vasopressin coincided with a decrease of urine volume to 0 ml.h-1. It was concluded that a large intake (10.3 l.7h-1) and retention (2.77 l.7h-1) of water and a "low normal" initial plasma Na+ (134 mEq.l-1) were primary factors in the development of HN in K.G., whereas Na+ losses in sweat and urine were normal and served only to exacerbate HN.

Adult↗
PubMed1996

Clozapine treatment in polydipsia and intermittent hyponatremia.

BACKGROUND: Recent case reports indicate that clozapine treatment diminishes excessive diurnal weight gain and alleviates hyponatremia observed in some chronically psychotic patients. We examined the influence of clozapine on sodium metabolism and water regulation across a group of patients with the syndrome of polydipsia and intermittent hyponatremia. METHOD: Eleven patients with treatment-resistant DSM-III-R schizophrenia or schizoaffective disorder were studied. Each had a history of repeated diurnal weight gains of greater than 10% with at least one documented bout of hyponatremia in the 6 months before clozapine treatment. We utilized a target weight protocol and serial laboratory measures to compare changes in sodium metabolism and water regulation during 26 weeks of standard antipsychotic medication and 26 weeks of clozapine treatment. RESULTS: Across patients, we found significant improvement in routinely monitored 6 a.m. and 4 p.m. serum sodium, reflecting normalization of sodium metabolism. We also found that the frequency (as reflected by diurnal weight gain), severity (lowest serum sodium), and estimated quantity (calculated urine volume) of polydipsia improved across patients. Improvement in polydipsia and hyponatremia was associated with decreased necessity for monitoring and restrictive interventions, and tended to be associated with psychiatric improvement. CONCLUSION: We found a corrective and stabilizing effect of clozapine on polydipsia and intermittent hyponatremia. Future studies need to examine the relationship of psychiatric improvement and alterations in the regulation of sodium and water physiology to our findings.

Adult↗
PubMed1997

[Disorders of water- and electrolyte balance in a triathlon. 2 case reports and review of the literature].

Triathlon is an increasingly popular sport. The number of active triathletes in Switzerland has increased greatly in recent years. We report two participants of the Zürcher Euroman. Triathlon 1995, who presented with clinically significant water and electrolyte disturbance. The race took place on a hot day and both athletes ingested large amounts of hypoosmolar fluids during and in case 1, after the competition. Case 1 was a 27 year old woman who developed generalized seizures one hour after finishing the race. She had confusion which persisted for several hours. The initial serum sodium concentration was 118 mmol/L. Case 2 was a 29 year old man who collapsed during the triathlon and was confused for hours afterwards. He presented with a serum sodium concentration of 120 mmol/L. Both patients had massive polyuria (first hour urine output of 900 ml, and 1300 ml respectively) that decreased in parallel with the normalization of the serum sodium. The pathophysiology, differential diagnosis and therapy of electrolyte and water disturbances in triathletes is discussed in relation to our two cases and the literature is reviewed.

Adult↗