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Cerebrospinal fluid losses through ventricular catheters leading to hyponatremia in two children
1Department of Anesthesiology/Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD.
Insights
Excessive cerebrospinal fluid (CSF) loss from ventricular drains can cause hyponatremia. Replacing CSF losses with normal saline (mL for mL) is an effective treatment for this condition.
Area of Science:
- Neurosurgery
- Neurology
- Nephrology
Background:
- Ventricular drains are used for hydrocephalus treatment and intracranial pressure monitoring.
- Excessive cerebrospinal fluid (CSF) loss can occur through these drains.
- CSF loss can lead to hyponatremia, a dangerous electrolyte imbalance.
Abstract:
I have presented two cases of patients with hyponatremia due to excessive cerebrospinal fluid losses from ventricular drains. The possibility of such losses exists whether the drain is used to treat hydrocephalus or to monitor intracranial pressure. I find normal saline (sodium concentration = 154 mEq/L) to be an appropriate fluid to replace ongoing losses of cerebrospinal fluid from a ventricular drain and currently start such replacement therapy (mL for mL) when the drain is placed.