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8 Cards in this Set
- Front
- Back
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What causes cerebral salt wasting
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Natriuretic peptide esp BNP has been implicated to cause CSW
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What are the main difference between SIADH and CSW
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SIADH CSW
Plasma volume High Low Dehydration features Absent Present Serum osmolality Low Low Urinary sodium and chloride excreation Normal high CVP Normal Low Serum uric acid low Low Hemoconcentration absent present BUN/creat ratio Normal/low Increased Urine volume Normal Increased |
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When does the onset of CSW occur
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Occurs within first 10 days of neurolosurgical procedure or event
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Which provocative tests can be done to differentiate CSW from SIADH
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1. 100 ml of0.9 % Saline infusion- Hyponatremia is aggravated in SIADH but not in CSW
2. 20 mg of Furosemide infusion- Normalizes hyponatremia in SIADH, not in CSW |
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what is treatment of CSW
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Saline replinshment with Isotonic or Hypertonic saline
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Sodium should be increased at what rate in cases of CSW
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Not more than 0.7 meq/litre/hour - maximum of 20 meq/l
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Is there any role of Fludocortisone in patients with CSW
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Yes
However it is generally given only after replenishment of saline cannot counteract the natriuresis |
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What are the side effects of Fludocortisone
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1. Hypertension
2. Hypokalemia 3. Pulmonary edema |
