Caution in Correcting Hyponatremia in Patients on Vasopressin

Abstract

A 24-year-old male presented with status epilepticus requiring mechanical ventilation. The hospital stay was complicated by ventilator associated pneumonia and sepsis requiring vasopressin infusion to maintain his blood pressure. The patient developed hyposmolar hyponatremia (serum Na=126 mEq/L; serum osmolarity=265 Osm/L). Water restriction and discontinuation of vasopressin resulted in polyuria and an abrupt rise in serum sodium to 140 mEq/L, mimicking diabetes insipidus.