SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (SIADH)

what is Syndrome of Inappropriate Diuretic Hormone (SIADH)?

• excessive production of antidiuretic hormone (ADH)

• leads to excessive renal water reabsorption resulting in

  • water retention

  • increased total body water

  • dilutional hyponatremia

what causes Syndrome of Inappropriate Diuretic Hormone (SIADH)?

• CNS disturbances (stroke, hemorrhage, trauma)

• medications (carbamazepine, SSRIs)

• lung disease (pneumonia)

• malignancy (small cell lung cancer)

what are clinical manifestations of Syndrome of Inappropriate Diuretic Hormone (SIADH)?

• low urine output

• weight gain

• hypertension

• hyponatremia

  • changes in mental status (confusion, lethargy)

  • seizures and coma

what lab findings are to be expected with Syndrome of Inappropriate Diuretic Hormone (SIADH)?

• low urine volume

• increased urine specific gravity >1.030

• increased urine osmolality

• low serum osmolality

• low sodium levels

what are interventions for Syndrome of Inappropriate Diuretic Hormone (SIADH)?

• daily weights

• I/Os

• seizure precautions

• frequent neuro checks

• fluid restriction <800 ml/day

• diuretics to correct water retention

• oral salt tablets or IV hypertonic saline if hypona is severe

• vassopressin antagonists (tolvaptan)

• monitor electrolytes