title: Unexpected fatal hypernatremia after successful cardiopulmonary resuscitation with therapeutic hypothermia: a case report.
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.
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sang-Sik
authors.initials: SS
authors.lastname: Choi
authors.forename: Won Young
authors.initials: WY
authors.lastname: Kim
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.forename: Kyung-Su
authors.initials: KS
authors.lastname: Lim
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000628:therapy; D006801:Humans; D006955:Hypernatremia / Q000209:etiology*; D007036:Hypothermia, Induced / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000150:complications