Article Notes
Van Decar et al. on the diagnosis and management of intra-operative diabetes insipidus concludes:
For the average adult patient, urine output >125 mL/h is consistent with polyuria. Urinary osmolality and specific gravity should be obtained and levels <300 mOsm/kg and <1.003, respectively, are consistent with hypotonic urine.
It is prudent to rule out other causes of polyuria including hyperglycemia, uremia, or iatrogenic causes including diuretic or mannitol administration.
Serum electrolytes and osmolality should also be obtained, and a high sodium (>146 mmol/L) and plasma osmolality (>300 mOsm/kg) are typically seen with DI.
Treatment should focus on replacement of free water deficit with a balanced salt solution, pharmacotherapy including DDAVP or vasopressin as appropriate, and close monitoring of patient’s fluid and electrolyte status.