The Journal of Bone and Joint Surgery (American). 2008;90:634-636.
doi:10.2106/JBJS.G.01403
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Symptomatic Hyponatremia in Patients Undergoing Total Hip and Knee Arthroplasty

A Report of Three Cases

George S. Gluck, MD1 and Paul F. Lachiewicz, MD1

1 Department of Orthopaedics, University of North Carolina at Chapel Hill, 3151 Bioinformatics Building, CB 7055, Chapel Hill, NC 27599-7055
Investigation performed at the Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

The first 150 words of the full text of this article appear below.


   Introduction
 
Clinically important hyponatremia is relatively uncommon. This disorder manifests with symptoms attributable to cerebral edema that include anorexia, nausea and vomiting, confusion, slurred speech, lethargy, weakness, agitation, headache, and seizures1. Symptoms are generally seen in an acute setting (developing over forty-eight hours or less) with serum sodium levels at or below 125 mEq/L (125 mmol/L) or in the chronic setting with levels at or below 110 mEq/L (110 mmol/L)1. If the disorder is left untreated or is corrected too rapidly, permanent neurologic sequelae can result. Surgical stress is recognized as a common cause of hyponatremia, most frequently in association with transplant, abdominal, cardiovascular, and orthopaedic trauma surgery2,3. This electrolyte disorder is more commonly present in elderly female patients, in those with a lower body weight, and in those taking certain medications, such as thiazide diuretics and selective serotonin reuptake inhibitors2.

Hyponatremia has been reported as a . . . [Full Text of this Article]


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