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Postop diabetes insipidus: Rx

During the postoperative period, Diabetes insipidus (DI) is most commonly associated with:

  • Pituitary surgery
  • Traumatic brain injury
  • Subarachnoid hemorrhage (especially associated with an anterior communicating artery aneurysm)

Most patients with DI do NOT require specific treatment if they have ready access to fluids. Indeed, most DI after pituitary surgery is transient and no permanent. If patients do not have ready access to fluids (i.e. changes in mental status, npo, etc.) or when urination interferes with sleep, DDAVP is the treatment of choice. When using DDAVP, one bust be careful as overzealous treatment of DI results in SIADH.