This is the podcast surgery I see rounds.

My name is Dr. Jeffrey Guy.

I'm an associate professor of surgery and director of the burn center, Vanderbilt University School of Medicine.

Had a lot of emails lately requesting a discussion on issues of fluid and electrolytes.

And we've already done a podcast on potassium abnormalities.

And so this podcast, I want to focus a little bit more on sodium, problems with hyponatremia or low sodium,

and problems with hypernatremia or a high sodium

and in subsequent podcasts and deal with some more of the issues regarding fluid and electrolytes

regarding different types of crystalloids and colloids the matter of where you work it really seems

like problems with sodium metabolism both sodium being elevated and depressed are relatively

common.

And for that reason, we'll start initially with a discussion of some of the things regarding

hyponatremia or a low sodium level.

And perhaps its most severe manifestation as far as symptoms go, when a patient has a low sodium, it can manifest itself as something called a hypoenetremic

encephalopathy.

I remember seeing a board question once where a patient who had a seemingly minor head injury

was admitted to the hospital, and subsequently their fluids were managed, such the patient developed

almost an iatrogenic hyponatremia, and there was a deterioration of the patient's metal status.

And in the solution of that question, the authors were pointing out the fact that when you have

hyponatremia, you can have edema or swelling or what we call fluid shifts, and that

would result in some cerebral edema, and hence the change in that particular patient's

metal status.

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