Management of early postoperative XXXX with parenteral desmopressin.

@entity1 @entity7062 @entity5463 @entity5225 @entity2753 @entity2010
Management of early postneurosurgical @entity2010 ( @entity2010 ) requires parenteral vasopressin before intranasal administration of desmopressin-1 desamino-8 D @entity5463 ( @entity7062 ) can be initiated. We have evaluated in 15 neurosurgical @entity1 the effect and the tolerance of a 3-day regimen of dDAVP administered im every 12 h. @entity1 were randomly ascribed to one of 3 treatment groups: 1 microgram (N = 6), 2 micrograms (N = 5) or 4 micrograms (N = 4) were administered twice daily. dDAVP was effective whatever the dose, and @entity2010 was corrected by the 6th h of treatment. Effects were maximal on diuresis and urinary osmolality from the 18th h onwards. The effects were sustained throughout the treatment period. Reversal to pretreatment status occurred 24 h after the last injection. Moreover, 72 h after the last injection, natremia and osmolality reached values significantly below pretherapeutic values. The tolerance was excellent: @entity2753 which occurred in 11 @entity1 , either occasionally or throughout the treatment period, remained mild and never had clinical consequences. In conclusion, before initiation of intranasal dDAVP, a 3-day treatment by 1, 2 or 4 micrograms of dDAVP injected im twice daily in neurosurgical @entity1 corrected @entity2010 . Mild @entity5225 owing to a positive fluid balance was a side-effect which is also encountered in other therapeutic methods necessitating meticulous control of water intake.
