{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T08:37:52Z","timestamp":1769330272021,"version":"3.49.0"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,4]]},"abstract":"\nObject<\/jats:title>\nFollowing successful transsphenoidal surgery in patients with growth hormone (GH)\u2013secreting pituitary adenomas, a characteristic fluid diuresis has been described. In this paper the authors aimed to further analyze the degree of fluid diuresis as it relates to postoperative GH levels.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nBetween 2000 and 2008, 85 patients underwent transsphenoidal surgery for a GH-secreting adenoma at the USC University Hospital. A retrospective chart review was conducted. Postoperative fluid intake, output, and balance within 48 hours following surgery, as well as endocrinological data were recorded and analyzed. Patients with postoperative diabetes insipidus and those with insufficient data were excluded from analysis.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nSeventy-one patients were included in the analysis. The mean age was 46 years (range 16\u201374 years). There were 36 males (51%) and 35 females (49%). Patients with negative fluid balances at 48 hours after surgery were more than twice as likely to have a GH level of < 1.5 ng\/ml (55 vs 25%, p = 0.023). At 48 hours after surgery, patients with a negative overall fluid balance had a significantly lower median GH level than those with a positive overall fluid balance (1.3 vs 2.4 ng\/ml, p = 0.039). This difference was even more pronounced in patients with microadenomas and a negative overall fluid balance. By 48 hours following surgery, patients with postoperative Day 1 GH levels < 1.5 ng\/ml had, on average, experienced diuresis of fluid > 1.1 L (median 1.5 L) more than patients with GH levels > 1.5 ng\/ml.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nSuccessful resection of GH-secreting adenomas is associated with a more pronounced fluid diuresis and negative overall fluid balance within 48 hours following transsphenoidal surgery. Patients with a negative fluid balance by postoperative Day 2 have a higher likelihood of having significantly reduced postoperative GH levels that may correlate with long-term surgical remission.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.7.jns09438","type":"journal-article","created":{"date-parts":[[2009,8,21]],"date-time":"2009-08-21T16:51:20Z","timestamp":1250873480000},"page":"744-749","source":"Crossref","is-referenced-by-count":22,"title":["Significance of postoperative fluid diuresis in patients undergoing transsphenoidal surgery for growth hormone\u2013secreting pituitary adenomas"],"prefix":"10.3171","volume":"112","author":[{"given":"Gabriel","family":"Zada","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walavan","family":"Sivakumar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn","family":"Fishback","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Singer","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin H.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-1120744","series-title":"J Clin Endocrinol Metab","first-page":"73","article-title":"Plasma renin activity and aldosterone secretion in patients with acromegaly","volume":"34","author":"Cain","year":"1972"},{"key":"b2-1120744","series-title":"Am J Physiol Renal Physiol","first-page":"F723","article-title":"Acute growth hormone administration induces antidiuretic and antinatriuretic effects and increases phosphorylation of NKCC2","volume":"292","author":"Dimke","year":"2007"},{"key":"b3-1120744","series-title":"Mol Cell Endocrinol","first-page":"109","article-title":"Effect of chronic GH overproduction on cardiac ANP expression and circulating ANP levels","volume":"144","author":"Dirsch","year":"1998"},{"key":"b4-1120744","series-title":"J Clin Endocrinol Metab","first-page":"418","article-title":"Hypersecretion of arginine vasopressin in acromegaly","volume":"33","author":"Doyle","year":"1971"},{"issue":"Suppl 1","key":"b5-1120744","series-title":"J Endocrinol","first-page":"S53","article-title":"Evidence supporting surgery as treatment of choice for acromegaly","volume":"155","author":"Fahlbusch","year":"1997"},{"key":"b6-1120744","series-title":"J Neurosurg","first-page":"353","article-title":"Long-term endocrinological follow-up evaluation in 115 patients who underwent transsphenoidal surgery for acromegaly","volume":"89","author":"Freda","year":"1998"},{"issue":"Suppl 1","key":"b7-1120744","series-title":"Horm Res","first-page":"44","article-title":"Role of growth hormone in fluid homeostasis","volume":"36","author":"Ho","year":"1991"},{"key":"b8-1120744","series-title":"Metabolism","first-page":"133","article-title":"The antinatriuretic action of biosynthetic human growth hormone in man involves activation of the renin-angiotensin system","volume":"39","author":"Ho","year":"1990"},{"key":"b9-1120744","series-title":"Eur J Endocrinol","first-page":"193","article-title":"Impact of successful transsphenoidal surgery on cardiovascular risk factors in acromegaly","volume":"148","author":"Jaffrain-Rea","year":"2003"},{"key":"b10-1120744","series-title":"J Clin Endocrinol Metab","first-page":"4072","article-title":"Surgical management of GH-secreting pituitary adenomas: an outcome study using modern remission criteria","volume":"86","author":"Kreutzer","year":"2001"},{"key":"b11-1120744","series-title":"J Neurosurg","first-page":"719","article-title":"Assessment of long-term remission of acromegaly following surgery","volume":"98","author":"Krieger","year":"2003"},{"key":"b12-1120744","series-title":"Rev Endocr Metab Disord","first-page":"67","article-title":"Surgery for acromegaly: evolution of the techniques and outcomes","volume":"9","author":"Laws","year":"2008"},{"key":"b13-1120744","series-title":"Proc Soc Exp Biol Med","first-page":"1156","article-title":"Characteristics of the antinatriuretic action of growth hormone","volume":"130","author":"Ludens","year":"1969"},{"key":"b14-1120744","series-title":"The Pituitary","first-page":"413","article-title":"Acromegaly","author":"Melmed","year":"1995"},{"key":"b15-1120744","series-title":"Endocr Relat Cancer","first-page":"611","article-title":"Evolving criteria for post-operative biochemical remission of acromegaly: can we achieve a definitive cure? 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