Acute Severe Hyponatremia following Hysteroscopic Procedure in a Young Patient: A Case Report and Review of the Literature

Table 2

Overview of reported cases with acute symptomatic hyponatremia during hysteroscopic procedures.

Case report	Lowest Na+ level, mmol/L	Normal plasma Na+ after, h	Est. fluid absorption, L	Irrigation fluid used	Max. fluid pressure, mmHg	Surgery time, min	Treatment for hyponatremia	First clinical manifestation	Presence of pulmonary edema	Type of anesthesia	Discharge day
Okazaki et al. [31]	84.1	15	7	3% d-sorbitol solution	N/A	123	Furosemide; 1.5% saline; acetate Ringer	Edemas in the conjunctiva, lip, and fingers	Yes	GA	6
Palanisamy et al. [32]	125	N/A	N/A	1.5% glycine	100	120	Furosemide	Abdominal distension and facial puffiness	No	GA	N/A
Liao et al. [33]	125	3	N/A	5% dextrose water	N/A	N/A	Sodium bicarbonate, 3% NaCl; mannitol; furosemide	Postoperative cardiac arrest	Yes	GA	28
Elegante et al. [34]	125	6	2.7	1.5% glycine	N/A	30	Furosemide	Hypoxia; dyspnea and altered mental status	Yes	N/A	Day 2
Chauha et al. [35]	111	6	N/A	1.5% glycine	90	120	Furosemide	Swelling of the face and vision problem	No	GA	Day 1
Sultan [36]	119	3	1.2	1.5% glycine	100	65	Furosemide	Confusion	No	Spinal anesthesia	Day 2
Hepp et al. [37]	74	7	5	2.7% sorbitol and 0.54% mannitol	120	70	3% NaCl; furosemide	Dyspnea	Yes	GA	Day 3
Almonti et al. [38]	120	10	2	1.5% glycine	N/A	60	7% NaCl; furosemide; mannitol	Myoclonus	No	GA	Day 2
Yaprak et al. [9]	99	14	5	Mannitol 5%	N/A	N/A	3% NaCl; furosemide	Altered mental status and agitation	No	N/A	Day 2
Sethi et al. [7]	100	N/A	1	1.5% glycine	80	45	3% NaCl; furosemide; sodium bicarbonate	Hypoxia	Yes	GA	Day 14
Yang and Feng [10]	120	12	3	Dextrose 5%	150	70	3% NaCl; furosemide	Flatulence and coma	No	N/A	N/A
Woo et al. [8]	87	48	24	2.7% sorbitol and 0.54% mannitol	150	60	3% NaCl; furosemide	Dyspnea	Yes	GA	Day 7
Wegmuller et al. [39]	78	36	N/A	2.7% sorbitol and 0.54% mannitol	100	80	Furosemide; hypertonic NaCl; bicarbonate 8.4%	Desaturation and laryngeal edema	Yes	Spinal anesthesia	Day 30
Jo et al. [5]	83	24	N/A	5:1 sorbitol/mannitol	120	150	Furosemide; 3% NaCl	Hypoxia	Yes	GA	Day 4
Serocki et al. [40]	106	24	0.4 L–4	2.7% sorbitol and 0.54% mannitol	180	25	0.9% NaCl	Hypoxia	Yes	GA	Day 2
Lee et al. [41]	89	24	7	2.7% sorbitol and 0.54% mannitol	100	40	2% NaCl; sodium bicarbonate; furosemide;	Hypotonia and bleeding leading to hysterectomy	No	GA	Day 2
Estes and Maye [42]	122	8	2.4	1.5% glycine	N/A	90	Furosemide	N/A	No	GA	Day 1
Arieff and Ayus [43]	137	N/A	N/A	3% sorbitol and 1.5% glycine	N/A	156 ± 24	Hypertonic (514 mmol/L) sodium chloride	Tremulousness, hypothermia, hypoxia, postoperative: Headache, nausea, emesis, and seizures	No	GA	N/A