title: Choice of fluid therapy in patients of craniopharyngioma in the perioperative period: A hospital-based preliminary study.
abstract: BACKGROUND
  Electrolyte imbalance and acute diabetes insipidus (DI) are the most common complications in patients undergoing craniopharyngioma surgery. Improper management of water and electrolyte imbalance is common cause of morbidity and mortality. Data is sparse and controversial regarding the choice of fluid therapy in this population during perioperative period.
  
  
  METHODS
  In this retrospective-prospective study involving 73 patients (58 retrospective), the type of fluid therapy was correlated with occurrence of hypernatremia, hyponatremia, DI, morbidity, and mortality. In the retrospective study, 48 patients received normal saline and 10 received mixed fluids as per the prevailing practice. In the prospective group, five patients each received normal saline, half normal saline, and 5% dextrose randomly.
  
  
  RESULTS
  The sodium values were significantly higher in first 48 h in the group that received normal saline compared with other groups (P < 0.001). The use of normal saline was associated with higher incidence of hypernatremia, DI, and mortality (P = 0.05), while the group that received 5% dextrose was associated with hyponatremia, hypoglycemia, and seizures. There was no perioperative hypotension with use of any of the fluids.
  
  
  CONCLUSIONS
  Our results indicate half normal saline was fluid of choice with diminished incidence of water and electrolyte abnormalities without increase in mortality during postoperative period.
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: K K
authors.initials: KK
authors.lastname: Mukherjee
authors.affiliation: Department of Endocrinology, PGIMER, Chandigarh, India.
authors.forename: Pinaki
authors.initials: P
authors.lastname: Dutta
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: Apinderpreet
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: Prakamya
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Pharmacology, PGIMER, Chandigarh, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Srinivasan
authors.affiliation: Department of Anaesthesia, PGIMER, Chandigarh, India.
authors.forename: Hemant
authors.initials: H
authors.lastname: Bhagat
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: S N
authors.initials: SN
authors.lastname: Mathuriya
authors.affiliation: Department of Endocrinology, PGIMER, Chandigarh, India, ; Barbra Davis Center for Diabetes, Aurora, Co, USA.
authors.forename: Viral N
authors.initials: VN
authors.lastname: Shah
authors.affiliation: Department of Endocrinology, PGIMER, Chandigarh, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhansali
keywords: Craniopharyngioma; diabetes insipidus; half normal saline; hypernatremia
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