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Post-operative hyponatraemia in orthopaedic injury
A A Tambe1, R Hill, P J Livesley
1Sherwood Hospitals NHS Trust, Mansfield Road, Sutton in Ashfield NG 17 4JL, UK. ktambes@aol.com
Injury
|April 2, 2003
Summary
Post-operative hyponatraemia, a dangerous electrolyte imbalance, occurred in 2.8% of orthopaedic surgery patients. Avoiding dextrose-containing fluids can prevent this condition, particularly in elderly individuals.
Area of Science:
- Medicine
- Clinical Chemistry
- Nephrology
Background:
- Post-operative hyponatraemia is a serious complication often misdiagnosed.
- Dextrose-containing fluid infusions are a known cause of this electrolyte imbalance.
Purpose of the Study:
- To determine the incidence of post-operative hyponatraemia in patients undergoing orthopaedic surgery.
- To highlight the risk factors and preventative measures for this condition.
Main Methods:
- Retrospective study analyzing medical notes and fluid charts of 1131 orthopaedic surgery patients.
- Statistical analysis of pre-operative and post-operative serum sodium levels and fluid intake.
Main Results:
- Identified 32 cases of post-operative hyponatraemia, an incidence of 2.8%.
- Mean serum sodium decreased significantly from 134 mmol/l pre-operatively to 126 mmol/l post-operatively (P<0.0001).
- Patients received an average of 3.26 L of dextrose-containing fluids.
Conclusions:
- Orthopaedic surgery poses a significant risk of hyponatraemia, especially in the elderly.
- Careful formulation of fluid infusion regimens, excluding dextrose-containing fluids, is crucial for prevention.
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