Massive irrigation during Endoscopic urologic surgery Normal saline versus distilled water; A prospective randomized trial

Abstract

Hyponatremia is commonly defined as a serum sodium concentration below 135 meq/L but can vary to a small degree in different clinical laboratories. The dilutional fall in serum sodium is in most patients associated with a proportional reduction in the serum osmolality (ie, to a level below 275 mosmol/kg), In virtually all patients, hyponatremia results from the intake (either oral or intravenous) and subsequent retention of water. A water load will, in normal individuals, be rapidly excreted as the dilutional fall in serum osmolality suppresses the release of antidiuretic hormone (ADH, also called vasopressin). thereby allowing excretion of the excess water in a dilute urine (Danziger and Zeidel, 2015).