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Article
February 2, 1994

Hyponatremic Encephalopathy After Endometrial Ablation-Reply

Author Affiliations

University of California, San Francisco
Baylor College of Medicine Houston, Tex

JAMA. 1994;271(5):345. doi:10.1001/jama.1994.03510290025020
Abstract

In Reply.  —Dr Lyon points out that during endometrial ablation, a discrepancy between intake and output would be reflected by a weight gain. This appears to be an excellent way to monitor fluid balance in such patients.Dr Mangar recommends careful monitoring of the patient undergoing hysteroscopy, including frequent measurements of serum electrolyte levels and the quantity of irrigating fluid used. Such a cautious approach should contribute toward prevention of the syndrome that we described.Dr O'Connor recommends use of an ethanol-containing irrigation fluid, combined with end-tidal breath analysis for ethanol levels. This apparently has been successful during TURP. An increased breath alcohol level in expired air would alert the physician that an excess of fluid had been reabsorbed. This could be an excellent way to monitor such patients, if the required technology were widely available.Dr Corson, alarmingly, suggests vasopressin administration to patients undergoing endometrial ablation. Many of the

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