Diabetes Insipidus In Patients With Traumatic Severe Brain Injury

Yudha Adi Prabowo, Prananda Surya Airlangga

Abstract

ABSTRACT

Traumatic severe brain injury is a fatal injury, with a mortality rate of up to 50%. About 1.5 million people experience severe brain injury in the United States. There are more than 50,000 deaths and 500,000 incidents of permanent neurological sequelae. About 85% of mortality occurs in the first 2 weeks after the injury. One complication of a severe brain injury is diabetes insipidus. There are no definitive data on the incidence of diabetes insipidus in patients with traumatic severe brain injury of Indonesia so far. In this case report, a male, 45 years old, was taken to the Emergency Installation (IRD) after experiencing a traffic accident 12 hours before being hospitalized. After surgery, the signs of diabetes insipidus was presented by polyuria of 300cc / hour urine production and 149mmol / L hypernatremia, although the immediate administration of desmopressin, the patients clinical and hemodynamic was not shown any improvements. The patient passed away in the days five of treatment in the Intensive Care Unit (ICU). The main treatments for diabetes insipidus in traumatic severe brain injury are adequate rehydration and administration of desmopressin. Adequate hypovolemic, polyuric and hypernatremia corrections are the keys to the successful treatment of diabetes insipidus. Diabetes insipidus in cases of brain injury requires complicated treatment. Therefore, in the case of being handled improperly, it can bring death.

 

Keywords: Diabetes insipidus, brain injury, hypernatremia, desmopressin, ICU

Correspondence: yud180987@yahoo.com

 

ABSTRAK

Cedera otak berat traumatis adalah cedera fatal, dengan tingkat kematian hingga 50%. Sekitar 1,5 juta orang mengalami cedera otak berat di Amerika Serikat. Terdapat lebih dari 50.000 kematian dan 500.000 insiden gangguan neurologis permanen. Sekitar 85% kematian terjadi dalam 2 minggu pertama setelah cedera. Salah satu komplikasi dari cedera otak yang parah adalah diabetes insipidus. Tidak ada data pasti tentang kejadian diabetes insipidus pada pasien dengan cedera otak traumatis berat di Indonesia sejauh ini. Pada laporan kasus ini, seorang pria, 45 tahun, dibawa ke Instalasi Rawat Darurat (IRD) setelah mengalami kecelakaan lalu lintas 12 jam sebelum dirawat di rumah sakit. Setelah operasi, tanda-tanda diabetes insipidus ditandai dengan adanya poliuria produksi urin 300cc / jam dan hipernatremia 149 mmol / L, meskipun segera diberikan desmopresin, kondis klinis dan hemodinamik pasien tidak menunjukkan perbaikan. Pasien meninggal pada hari kelima perawatan di Unit Perawatan Intensif (ICU). Perawatan utama untuk diabetes insipidus pada cedera otak berat traumatis adalah rehidrasi dan pemberian desmopresin yang adekuat. Koreksi hipovolemik, poliurik, dan hipernatremia yang adekuat adalah kunci keberhasilan pengobatan diabetes insipidus. Diabetes insipidus dalam kasus cedera otak membutuhkan perawatan yang rumit. Karena itu, jika ditangani dengan tidak tepat, bisa menyebabkan kematian. 

 

Kata kunci: Diabetes insipidus, cedera otak, hipernatremia, desmopressin, ICU

Korespondensi: yud180987@yahoo.com

Keywords

Diabetes Insipidus, Cedera otak, Hipernatremia, Desmopresin, Osmolaritas

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DOI: http://dx.doi.org/10.30651/jqm.v3i2.2534