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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35798
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My Father in-law just had major surgery repairing aortic

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My Father in-law just had major surgery repairing aortic aneurysm ascending from the arch and with pressure on the spine also repaired one in his abdomin. He has Marfans Syndrom. Three days ago they told us he had pneumonia and today they say he has next to no sodium in his blood and both lungs are filling with fluid. He has been bloated badly since he came out of ICU and always fealt full when we tried to feed him. We did walk him two times a day but is now going down hill fast, they also put a catheder in him today and another big IV line with nothing on it. He has been on IV antibiotics and IV saline for three days now. Whats happening?


I am sorry that your question was unanswered for long.

An infection like pneumonia can be responsible for all his symptoms and complications. The feeling of fullness, bloating or loss of appetite occurs in infection. Pneumonia can fill the fluid in the lungs (called pleural effusion or pulmonary edema). Following condition can cause sodium deficiency;

1) High blood sugar (diabetes)

2) Hyperlipidemia (high cholesterol and triglycerides)

3) Paraproteinemia; increased proteins in the body

4) Medications like diuretic

5) Kidney diseases affecting renin-angiotensin system

6) Antidiuretic hormone (ADH) secretion

7) Salt-wasting nephropathy (kidney disease)

8) Liver cirrhosis,

9) Congestive heart failure,

10) Nephrotic syndrome,

11) Nonsteroidal anti-inflammatory drug (NSAID) use may increase the risk of development of hyponatremia

12) Excessive exercises

Investigations to assess the causes for low sodium are;

1) Urine osmolality

2) Serum osmolality

3) Urinary sodium concentration

4) Serum albumin,

5) Serum triglycerides,

6) Serum protein electrophoresis

7) Thyroid-stimulating hormone (TSH)

8) Serum cortisol levels

9) Serum uric acid levels

The treatment is dependent on the severity of deficiency of sodium, mode of onset and cause. If it is severe and sudden, intravenous saline drips is required, otherwise oral increased table salts with periodic monitoring of the blood levels of the sodium and management of the cause (like kidney disease will need dialysis) takes care of the deficiency. In his case a combination of congestive heart failure, pneumonia and kidney disease are the likely possibility of the low sodium. With the antibiotics, infection would be controlled and gradually rest of the complication also gradually are likely to resolve.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Dr. Arun Phophalia and 3 other Health Specialists are ready to help you
Customer: replied 5 years ago.
Thank you so much for the answer it sheds some light on the situation because they don't seem to be answering our questions in the hospital
You are very welcome.

Good luck.