What postoperative monitoring should be performed to screen for diabetes insipidus (DI)?

Updated: Mar 18, 2020
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

After pituitary surgery, patients should undergo continuous monitoring of fluid intake, urinary output, and specific gravities, along with daily measurements of serum electrolytes. [39] In patients who develop DI, administer parenteral desmopressin every 12-24 hours, along with adequate fluid to match losses.

Follow the specific gravity of the urine, and administer the next dose of desmopressin when the specific gravity has fallen to less than 1.008-1.005 with an increase in urine output. When the patient can tolerate oral intake, thirst can become an adequate guide.

In patients with DI who have undergone surgery of any kind, administer the usual dose of desmopressin and give (hypotonic) IV fluids to match urinary output.


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