Severe hyponatremia after repeated intravenous administration of desmopressin. Am J Hematol 1989 Dec;32(4):258-61
Date
12/01/1989Pubmed ID
2816922DOI
10.1002/ajh.2830320405Scopus ID
2-s2.0-0024313564 (requires institutional sign-in at Scopus site) 47 CitationsAbstract
Desmopressin (DDAVP) has recently been found to improve hemostasis in patients with congenital or acquired disorders of coagulation and to reduce operative blood loss in patients with normal hemostasis undergoing certain surgical procedures. Despite its potent antidiuretic effect, severe hyponatremia after the intravenous administration of DDAVP is felt to be rare. We report four cases of severe hyponatremia with serious clinical sequelae occurring in patients with underlying coagulopathies who were treated prophylactically with DDAVP to improve hemostasis prior to surgical procedures. Each patient received multiple (3-22) doses of DDAVP and was given intravenous hydration with hypotonic solutions before developing clinical signs and laboratory evidence of hyponatremia. We believe that the risk of significant hyponatremia after treatment with intravenous DDAVP may be higher than is generally appreciated and that patients undergoing surgical procedures, who often receive multiple doses of DDAVP and intravenous hydration, are at particular risk for this complication. Hypotonic intravenous solutions should be avoided and serum sodium levels should be monitored frequently in those patients receiving multiple doses of DDAVP.
Author List
Weinstein RE, Bona RD, Altman AJ, Quinn JJ, Weisman SJ, Bartolomeo A, Rickles FRAuthor
Steven J. Weisman MD Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdenoidectomyAdolescent
Adult
Cesarean Section
Child, Preschool
Deamino Arginine Vasopressin
Drainage
Female
Hemophilia A
Hemostasis, Surgical
Humans
Hyponatremia
Male
Thrombocytopenia
Tonsillectomy
von Willebrand Diseases
