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Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Daniel Stairs, CRNA, MSN, MBA Excela Health School of Anesthesia. SIADH. Results from abnormal production or sustained secretion of ADH Associated with many clinical states, syndromes, drugs. SIADH. Most frequent cause is cancer
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Syndrome of Inappropriate Antidiuretic Hormone(SIADH) Daniel Stairs, CRNA, MSN, MBA Excela Health School of Anesthesia
SIADH • Results from abnormal production or sustained secretion of ADH • Associated with many clinical states, syndromes, drugs
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
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
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
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