J Korean Med Sci.  2012 Mar;27(3):329-331. 10.3346/jkms.2012.27.3.329.

Unexpected Fatal Hypernatremia after Successful Cardiopulmonary Resuscitation with Therapeutic Hypothermia: A Case Report

• Choi SS
• Kim WY
• Kim W
• Lim KS

• KMID: 1793008
• DOI: http://doi.org/10.3346/jkms.2012.27.3.329

Abstract

Central diabetes insipidus (DI), characterized by unexpected fatal hypernatremia, is a rare complication after successful cardiopulmonary resuscitation with therapeutic hypothermia, but may be potentially fatal if recognition is delayed. We describe here a patient who experienced cardiac arrest due to a pulmonary embolism, followed by successful resuscitation after induction of therapeutic hypothermia. The patient, however, suddenly developed unexpected hypernatremia with increased urine output and was diagnosed with central DI as a complication of cerebral edema, and eventually died. Our findings suggest that central DI should be considered as a possible complication following unexpected hypernatremia with increased urine output during therapeutic hypothermia and that desmopressin acetate should be used to treat central DI.

Keyword

Hypernatremia; Diabetes Insipidus; Hypoxia, Brain; Hypothermia, Induced

MeSH Terms

Adult
Cardiopulmonary Resuscitation/*adverse effects
Diabetes Insipidus, Neurogenic/diagnosis/etiology
Fatal Outcome
Female
Heart Arrest/complications/therapy
Humans
Hypernatremia/*etiology
Hypothermia, Induced/*adverse effects
Pulmonary Embolism/complications

Figure

• 

  Fig. 1 Trends of sodium level (mM/L) after admission.

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