Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

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Syndrome of Inappropriate Antidiuretic
Hormone(SIADH)

• Daniel Stairs, CRNA, MSN, MBA
• Excela Health School of Anesthesia

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SIADH

• Results from abnormal production or sustained
  secretion of ADH
• Associated with many clinical states, syndromes,
  drugs

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SIADH

• Most frequent cause is cancer
• Especially small cell or oat cell cancer of lung
• Since SIADH can precede the diagnosis of a tumor,
  it should always be viewed as potential marker of
  underlying malignancy

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SIADH

• Some pulmonary conditions associated with SIADH
  include bacterial pneumonias, COPD, TB, lung
  abcesses
• Malignancies of pancreas, duodenum, colon,
  lymphoid tissue, and thymus can also produce SIADH

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SIADH

• Diuretic, most commonly thiazides, have been
  related to SIADH occurrence
• Others antineoplastic drugs (vincristine),
  tricyclic antidepressants, nicotine have all been
  associated with increased amounts of circulating
  ADH

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SIADH

• Treatment Eliminate underlying cause
• Surgery, radiotherapy, chemo, for malignancy
  induced
• Fluid restrictions
• For pts with neurological symptoms of severe
  hyponatremia use of a hypertonic sodium
  chloride solution