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Antidiuretic hormone following surgery in children
B A Judd1, G B Haycock, R N Dalton
1Evelina Children's Department, United Medical School, Guy's Hospital, London, England.
Acta Paediatrica Scandinavica
|April 1, 1990
Summary
Supplemental intravenous fluids prevent hypovolemia and antidiuretic hormone (ADH) release during pediatric tonsillectomy. Maintaining fluid balance is crucial to avoid complications like hyponatremia.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Nephrology
Background:
- Tonsillectomy is a common surgical procedure in children.
- Fluid management during and after surgery is critical for patient outcomes.
- Hypovolemia can lead to physiological stress responses, including antidiuretic hormone (ADH) release.
Purpose of the Study:
- To investigate the impact of supplemental intravenous isotonic saline on fluid balance and ADH release in children undergoing tonsillectomy.
- To determine if hypovolemia is the primary driver of ADH release post-tonsillectomy.
Main Methods:
- A comparative study of 13 children undergoing elective tonsillectomy.
- Study group (n=6) received intravenous isotonic saline.
- Control group (n=7) did not receive supplemental fluids.
- Clinical and biochemical parameters, including plasma ADH and urine osmolality, were monitored.
Main Results:
- Control patients exhibited clinical and biochemical signs of hypovolemia.
- Higher plasma ADH levels and urine osmolality were observed in the control group.
- Plasma sodium concentration and osmolality were comparable between groups, indicating no significant dilutional effect.
Conclusions:
- Hypovolemia is the main stimulus for ADH release following surgery.
- Preventing hypovolemia with maintenance isotonic fluids is recommended over fluid restriction.
- Avoidance of hypotonic and sodium-free fluids is essential to prevent hyponatremia.