Why be concerned with DI for TBI pts?

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Specializes in ICU, Triage, Home Health, primary care FNP.

I feel like I should know this as a neuro icu rn, but i don't. I'm a bit embarrassed to ask it. Anywho, I am aware that large amt of urine output is one of the symptoms of DI. But why is it that we should be concerned of DI for patients who sustained a traumatic brain injury? :uhoh21: Thanks in advance!

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Specializes in ICU, Neuro, Trauma, Gen Surg, Transplant.

DI is a concern in TBI pt's due to injury to the pituitary gland (specifically hemorrhage)

see:

http://www.emedicine.com/pmr/TOPIC109.HTM

http://www.ncbi.nlm.nih.gov/pubmed/16508710

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Specializes in Critical Care, ER.

You have to watch what it does to their electrolytes. High urine outputs can lead to low K, Mag, and Na levels in particular and all of the issues associated with electrolyte imbalances.

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It can also impair homestasis as it leads to hypovolemia and low BP.

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Specializes in Neuro, Critical Care.
I feel like I should know this as a neuro icu rn, but i don't. I'm a bit embarrassed to ask it. Anywho, I am aware that large amt of urine output is one of the symptoms of DI. But why is it that we should be concerned of DI for patients who sustained a traumatic brain injury? :uhoh21: Thanks in advance!

anytime blood gets near the pit. gland you run the risk of DI no matter how it got there. High Na and high UO low spec grav. are the main signs. Most of the time on our unit the docs dont really treat it besides keeping the pt hydrated and watching electrolytes. If its pretty bad then occasionally we will give DDAVP.

Also according to Hickey-DI can be idiopathic...ive never seen it but...

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