Difference between revisions of "Syndrome of inappropriate antidiuretic hormone secretion"

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Provide a brief summary of this comorbidity here.
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition in which ''excess'' anti-diuretic hormone (ADH) - also known as vasopressin - is produced. Downstream effects include 1. retention of excess water which can lead to cerebral edema/seizures/coma/death, 2. hyponatremia which can lead to arrhythmias and - if sodium corrected is attempted - potentially iatrogenic Osmotic demyelination syndrome (OSD)/Central pontine myelinolysis (CPM).  


== Anesthetic implications<!-- Briefly summarize the anesthetic implications of this comorbidity. --> ==
==Anesthetic implications<!-- Briefly summarize the anesthetic implications of this comorbidity. -->==


=== Preoperative optimization<!-- Describe how this comorbidity may influence preoperative evaluation and optimization of patients. --> ===
===Preoperative optimization<!-- Describe how this comorbidity may influence preoperative evaluation and optimization of patients. -->===


=== Intraoperative management<!-- Describe how this comorbidity may influence intraoperative management. --> ===
* Evaluate overall sodium trend
** Most anesthesiologists would consider delaying case if sodium x<130
** Ideally sodium should be corrected to normal limits or at least ''stabilized or trending towards correction'' prior to surgery
*** Uncorrected sodium levels merits discussion with internal medicine and surgery.


=== Postoperative management<!-- Describe how this comorbidity may influence postoperative management. --> ===
===Intraoperative management<!-- Describe how this comorbidity may influence intraoperative management. -->===


== Related surgical procedures<!-- List and briefly describe any procedures which may be performed specifically to treat this comorbidity or its sequelae. If none, this section may be removed. --> ==
===Postoperative management<!-- Describe how this comorbidity may influence postoperative management. -->===


== Pathophysiology<!-- Describe the pathophysiology of this comorbidity. Add subsections as needed. --> ==
==Related surgical procedures<!-- List and briefly describe any procedures which may be performed specifically to treat this comorbidity or its sequelae. If none, this section may be removed. -->==


== Signs and symptoms<!-- Describe the signs and symptoms of this comorbidity. --> ==
==Pathophysiology==
General Mechanism of Action of ADH


== Diagnosis<!-- Describe how this comorbidity is diagnosed. --> ==
* ADH is a hormone produced by the hypothalamus, then stored and released via the posterior pituitary gland
* ADH is responsible for mechanisms pertaining to water retention via upregulation of aquaporin channels in renal nephrons to increase water re-absorption. ADH's main effect leads to increased fluid volume while decreasing serum sodium concentration and decreasing urinary output volume.  


== Treatment<!-- Summarize the treatment of this comorbidity. Add subsections as needed. --> ==
Consequences


=== Medication<!-- Describe medications used to manage this comorbidity. --> ===
Causes


=== Surgery<!-- Describe surgical procedures used to treat this comorbidity. --> ===
* Cancer
** Brain tumors
** Small Cell Lung Cancer
** Lymphoma
* Central Nervous System
** Brain Surgery - especially pituitary gland surgery
** Brain tumors
** Meningitis
** Encephalitis
** Brain trauma
**


=== Prognosis<!-- Describe the prognosis of this comorbidity --> ===
==Signs and symptoms<!-- Describe the signs and symptoms of this comorbidity. -->==
[[File:Siadh vs di vs cerebral salt wasting.png|thumb]]


== Epidemiology<!-- Describe the epidemiology of this comorbidity --> ==
==Diagnosis==


== References ==
==Treatment<!-- Summarize the treatment of this comorbidity. Add subsections as needed. -->==


===Medication<!-- Describe medications used to manage this comorbidity. -->===
===Surgery<!-- Describe surgical procedures used to treat this comorbidity. -->===
===Prognosis<!-- Describe the prognosis of this comorbidity -->===
==Epidemiology<!-- Describe the epidemiology of this comorbidity -->==
==References==
<ref>{{Cite journal|last=Leung|first=Alexander A.|last2=McAlister|first2=Finlay A.|last3=Rogers|first3=Selwyn O., Jr|last4=Pazo|first4=Valeria|last5=Wright|first5=Adam|last6=Bates|first6=David W.|date=2012-10-22|title=Preoperative Hyponatremia and Perioperative Complications|url=https://doi.org/10.1001/archinternmed.2012.3992|journal=Archives of Internal Medicine|volume=172|issue=19|pages=1474–1481|doi=10.1001/archinternmed.2012.3992|issn=0003-9926}}</ref>
[[Category:Comorbidities]]
[[Category:Comorbidities]]

Revision as of 09:24, 29 June 2025

Syndrome of inappropriate antidiuretic hormone secretion
Anesthetic relevance
Anesthetic management

{{{anesthetic_management}}}

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Diagnosis
Treatment
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Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition in which excess anti-diuretic hormone (ADH) - also known as vasopressin - is produced. Downstream effects include 1. retention of excess water which can lead to cerebral edema/seizures/coma/death, 2. hyponatremia which can lead to arrhythmias and - if sodium corrected is attempted - potentially iatrogenic Osmotic demyelination syndrome (OSD)/Central pontine myelinolysis (CPM).

Anesthetic implications

Preoperative optimization

  • Evaluate overall sodium trend
    • Most anesthesiologists would consider delaying case if sodium x<130
    • Ideally sodium should be corrected to normal limits or at least stabilized or trending towards correction prior to surgery
      • Uncorrected sodium levels merits discussion with internal medicine and surgery.

Intraoperative management

Postoperative management

Related surgical procedures

Pathophysiology

General Mechanism of Action of ADH

  • ADH is a hormone produced by the hypothalamus, then stored and released via the posterior pituitary gland
  • ADH is responsible for mechanisms pertaining to water retention via upregulation of aquaporin channels in renal nephrons to increase water re-absorption. ADH's main effect leads to increased fluid volume while decreasing serum sodium concentration and decreasing urinary output volume.

Consequences

Causes

  • Cancer
    • Brain tumors
    • Small Cell Lung Cancer
    • Lymphoma
  • Central Nervous System
    • Brain Surgery - especially pituitary gland surgery
    • Brain tumors
    • Meningitis
    • Encephalitis
    • Brain trauma

Signs and symptoms

Siadh vs di vs cerebral salt wasting.png

Diagnosis

Treatment

Medication

Surgery

Prognosis

Epidemiology

References

[1]

  1. ↑ Leung, Alexander A.; McAlister, Finlay A.; Rogers, Selwyn O., Jr; Pazo, Valeria; Wright, Adam; Bates, David W. (2012-10-22). "Preoperative Hyponatremia and Perioperative Complications". Archives of Internal Medicine. 172 (19): 1474–1481. doi:10.1001/archinternmed.2012.3992. ISSN 0003-9926.

Top contributors: Jessica Leung and Olivia Sutton

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