Vasopressin Bolus Protocol Compared to Desmopressin (DDAVP) for Managing Acute, Postoperative Central Diabetes Insipidus and Hypovolemic Shock
Joint Authors
Newey, C. R.
Nattanmai, Premkumar
Bell, Robert
McCormick, Ashley
Shukla, Anukrati
Alqadri, Syeda
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-01-03
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Introduction.
Management of postoperative central diabetes insipidus (DI) can be challenging from changes in volume status and serum sodium levels.
We report a case successfully using a dilute vasopressin bolus protocol in managing hypovolemic shock in acute, postoperative, central DI.
Case Report.
Patient presented after bifrontal decompressive craniotomy for severe traumatic brain injury.
He developed increased urine output resulting in hypovolemia and hypernatremia.
He was resuscitated with intravenous fluids including a dilute vasopressin bolus protocol.
This protocol consisted of 1 unit of vasopressin in 1 liter of 0.45% normal saline.
This protocol was given in boluses based on the formula: urine output minus one hundred.
Initial serum sodium was 148 mmol/L, and one-hour urine output was 1 liter.
After 48 hours, he transitioned to 1-desamino-8-D-arginine vasopressin (DDAVP).
Pre-DDAVP serum sodium was 149 mmol/L and one-hour urine output 320 cc.
Comparing the bolus protocol to the DDAVP protocol, the average sodium was 143.8 ± 3.2 and 149.6 ± 3.2 mmol/L (p=0.0001), average urine output was 433.2 ± 354.4 and 422.3 ± 276.0 cc/hr (p=0.90), and average specific gravity was 1.019 ± 0.009 and 1.016 ± 0.01 (p=0.42), respectively.
Conclusion.
A protocol using dilute vasopressin bolus can be an alternative for managing acute, central DI postoperatively, particularly in setting of hypovolemic shock resulting in a consistent control of serum sodium.
American Psychological Association (APA)
Shukla, Anukrati& Alqadri, Syeda& McCormick, Ashley& Bell, Robert& Nattanmai, Premkumar& Newey, C. R.. 2017. Vasopressin Bolus Protocol Compared to Desmopressin (DDAVP) for Managing Acute, Postoperative Central Diabetes Insipidus and Hypovolemic Shock. Case Reports in Endocrinology،Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1145070
Modern Language Association (MLA)
Shukla, Anukrati…[et al.]. Vasopressin Bolus Protocol Compared to Desmopressin (DDAVP) for Managing Acute, Postoperative Central Diabetes Insipidus and Hypovolemic Shock. Case Reports in Endocrinology No. 2017 (2017), pp.1-4.
https://search.emarefa.net/detail/BIM-1145070
American Medical Association (AMA)
Shukla, Anukrati& Alqadri, Syeda& McCormick, Ashley& Bell, Robert& Nattanmai, Premkumar& Newey, C. R.. Vasopressin Bolus Protocol Compared to Desmopressin (DDAVP) for Managing Acute, Postoperative Central Diabetes Insipidus and Hypovolemic Shock. Case Reports in Endocrinology. 2017. Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1145070
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1145070