Desalination and hyponatremia

This review contends that "healthy" water in terms of electrolyte balance is as important as "pure" water in promoting public health. It considers the growing use of desalination (demineralization) technologies in drinking water treatment which often results in tap water with very low concentrations of sodium, potassium, magnesium and calcium. Ingestion of such water can lead to electrolyte abnormalities marked by hyponatremia, hypokalemia, hypomagnesemia and hypocalcemia which are among the most common and recognizable features in cancer patients...

Cerebral vasospasm is a well-known cause of mortality and morbidity following aneurysmal subarachnoid hemorrhage (SAH). Prevention of symptomatic cerebral vasospasm is the basic management after SAH. Numerous pharmaceutical therapies and endovascular treatments are available against cerebral vasospasm, but none of them have so far proven to improve the outcome. We have focused on maintaining the circulation volume in order to prevent cerebral vasospasm. But to maintain the central venous pressure, huge infusion volume was required, and hyponatremia was frequently observed due to natriuresis and osmotic diuresis...

OBJECTIVES: To review the current data on pathophysiology, causes and management of postoperative hyponatremia in children. DATA SOURCES AND EXTRACTION: The Pubmed database was searched for articles, combined with references analysis of major articles on the field. DATA SYNTHESIS: The incidence of postoperative hyponatremia has been evaluated at 0.34% and its mortality significant. Postoperative hyponatremia is triggered by the diminished renal ability to excrete free water, due to antidiuretic hormone release...

Derangements in plasma sodium concentration are best analyzed by carefully determining entries and output for water, sodium and potassium, that is, by calculating a tonicity balance. Five clinical hyponatremic examples are discussed: the beer drinker has a severe deficit in total body sodium: the elderly female patient treated with a thiazide needs to be firstly repleted in potassium; the hypertensive transplanted patient with a multidrug treatment requires an increase of the urinary electrolyte-free water which has been obtained by the oral administration of urea; the post-operative hyponatremic cases (cases 4 and 5) are complex and involve a desalination phenomenon...

BACKGROUND: It is widely presumed that the development of postoperative hyponatremia (which may be severe) results from administration of hypotonic fluids while antidiuretic hormone is acting. OBJECTIVE: To show that hyponatremia would occur in patients 24 hours after surgery if only near-isotonic solutions are given and to evaluate the mechanisms responsible for hyponatremia in this setting. DESIGN: Prospective cohort study. SETTING: University medical center...