Continuous Veno-Venous Haemofiltration in the Management of Severe Hyponatraemia Associated with Transurethral Resection of Prostate Syndrome

Modern surgical practice and anaesthetic vigilance has reduced the incidence of profound metabolic disturbance associated with absorption of irrigation fluid during endoscopic transurethral resection (TUR) of the prostate. We describe the critical care management of a patient with severe TUR syndrome, who was successfully managed with continuous veno-venous haemofiltration for the treatment of profound electrolyte disturbance, intravascular volume correction, and treatment of irrigation-fluid glycine toxicity. We examine the rationale for rapid and controlled correction of hyponatraemia in TUR syndrome.