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Diagnosis and Management of Combined Central Diabetes Insipidus and Cerebral Salt Wasting Syndrome After Traumatic Brain Injury 期刊论文

编号：

638fd8c4-db89-4620-8ea7-efa111b776ce
作者：

Wu, Xuehai(吴雪海)#^[1]Zhou, Xiaolan^[2];Gao, Liang(高亮)^[1]Wu, Xing(吴惺)^[1]Fei, Li(费力)^[3]Mao, Ying(毛颖)^[1]Hu, Jin(胡锦)*^[1]Zhou, Liangfu(周良辅)^[1]
语种：

English
期刊：

WORLD NEUROSURGERY ISSN：1878-8750 2016 年 88 卷 (483 - 487) ; APR
收录：
关键词：

Central diabetes insipidus Cerebral salt wasting syndrome Cortisone acetate Polyuria Traumatic brain injury Vasopressin
摘要：

BACKGROUND: Combined central diabetes insipidus and cerebral salt wasting syndrome after traumatic brain injury (TBI) is rare, is characterized by massive polyuria leading to severe water and electrolyte disturbances, and usually is associated with very high mortality mainly as a result of delayed diagnosis and improper management. METHODS: We retrospectively reviewed the clinical presentation, management, and outcomes of 11 patients who developed combined central diabetes insipidus and cerebral salt wasting syndrome after traumatic brain injury to define distinctive features for timely diagnosis and proper management. RESULTS: The most typical clinical presentation was massive polyuria (10,000 mL/24 hours or > 1000 mL/hour) refractory to vasopressin alone but responsive to vasopressin plus cortisone acetate. Other characteristic presentations included low central venous pressure, high brain natriuretic peptide precursor level without cardiac dysfunction, high 24-hour urine sodium excretion and hypovolemia, and much higher urine than serum osmolarity; normal serum sodium level and urine specific gravity can also be present. Timely and adequate infusion of sodium chloride was key in treatment. Of 11 patients, 5 had a good prognosis 3 months later (Extended Glasgow Outcome Scale score >= 6), 1 had an Extended Glasgow Outcome Scale score of 4, 2 died in the hospital of brain hernia, and 3 developed a vegetative state. CONCLUSIONS: For combined diabetes insipidus and cerebral salt wasting syndrome after traumatic brain injury, massive polyuria is a major typical presentation, and intensive monitoring of fluid and sodium status is key for timely diagnosis. To achieve a favorable outcome, proper sodium chloride supplementation and cortisone acetate and vasopressin coadministration are key.
推荐引用方式
GB/T 7714：

Wu Xuehai,Zhou Xiaolan,Gao Liang, et al. Diagnosis and Management of Combined Central Diabetes Insipidus and Cerebral Salt Wasting Syndrome After Traumatic Brain Injury [J].WORLD NEUROSURGERY,2016,88:483-487.
APA：

Wu Xuehai,Zhou Xiaolan,Gao Liang,Wu Xing,&Zhou Liangfu.(2016).Diagnosis and Management of Combined Central Diabetes Insipidus and Cerebral Salt Wasting Syndrome After Traumatic Brain Injury .WORLD NEUROSURGERY,88:483-487.
MLA：

Wu Xuehai, et al. "Diagnosis and Management of Combined Central Diabetes Insipidus and Cerebral Salt Wasting Syndrome After Traumatic Brain Injury" .WORLD NEUROSURGERY 88(2016):483-487.

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