Conclusions: Hypervolaemic hyponatraemia was the most common presentation in our study.
1 It usually results from disturbance in water homoeostasis2 and is classically divided into: hypervolaemic, euvolaemic and hypovolaemic hyponatraemia.
Aetiology of hyponatraemia was defined as a disease or condition directly responsible for the current episode of hyponatraemia based on estimation of volume status of patient determined by bedside clinical examination for presence or absence of peripheral oedema, jugular venous pressures (JVP), pulmonary rales, postural hypotension, decrease skin turgor and dry mucous membranes thus dividing the whole cohort into three classes: hypervolaemic, euvolaemic and hypovolaemic hyponatraemia.
Tolvaptan, a selective vasopressin V2-receptor antagonist, is the novel oral medication which is increasingly used in hypervolaemic
and euvolaemic hyponatraemia.
Jin et al, 2010 36 patients with Acute hypervolaemic
This therapy is quite appropriate for severely hypervolaemic
Other than maintaining normal physiological parameters, the two best described therapies for the prophylaxis of vasospasm are calcium channel antagonists (Cochrane Systematic Review, Grade A recommendation for oral nimodipine) (39) and hypervolaemic (hypertensive) therapy (Cochrane Systematic Review Grade D recommendation) (40).
There is no prospective evidence supporting the use of hypervolaemic or hypertensive therapy in the treatment of vasospasm (37,40,41) despite almost universal use of these strategies and the risk of associated significant morbidity (Grade D recommendation, Level 4 evidence) (41).