Journal
JOURNAL OF CLINICAL ANESTHESIA
Volume 24, Issue 5, Pages 407-411Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jclinane.2011.11.008
Keywords
Central pontine myelinolysis; Continuous venovenous hemodiafiltration; Hyponatremia; Orthotopic liver transplantation
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Two patients in end-stage hepatic failure presented for orthotopic liver transplantation with longstanding severe hyponatremia (121 and 122 mmol/L). Both patients underwent liver transplantation with the concomitant use of continuous venovenous hemodiafiltration. Replacement and dialysate solutions were prepared individually to contain a sodium level that was individually considered safe with regard to the development of central pontine myelinolysis. The sodium increase in both patients was within the expected and planned limits despite a situation of mass transfusion. Both patients did well postoperatively and neither patient suffered neurological deficits. (C) 2012 Elsevier Inc. All rights reserved.
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