{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:46:52Z","timestamp":1791985612949,"version":"4.4.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective(s):<\/jats:title>\n                    <jats:p>The conundrum of Polyuria witnessed post-cardiac surgery has been attributed to altered antidiuretic hormone (ADH) release secondary to both osmotic and non-osmotic stimulus. This transient DI-like state is more often seen in on-bypass cardiac surgeries but a few off-bypass occurrences have also been reported. A lot of conflicting evidence has accumulated trying to explain this altered water balance but a broader conceptual framework is lacking, which we have attempted to provide, with an objective of designing a future prospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design; Setting; Participants; Interventions:<\/jats:title>\n                    <jats:p>This prospective observational case-series included 12 cases, who underwent off pump coronary artery bypass grafting (OPCABG) at a single tertiary care hospital. All were operated and managed by the same anesthetist-cardiac surgeon team following a structured protocol, hence negating various confounders. Serum and urine osmolality samples were collected post-Intubation (Baseline) and within 1 hour of ICU-transfer and all relevant data associated with these cases was recorded for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results:<\/jats:title>\n                    <jats:p>\n                      The data was systematically analyzed in terms of descriptives, paired T-test and correlation statistics. The pre-post serum osmolality was found to increase (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value 0.389, Cohen\u2019s d \u20130.26) whereas urine osmolality decreased significantly (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value 0.013, Cohen\u2019s d 0.85). This mean fall in urine osmolality was much higher compared to the rise seen in serum osmolality, both being negatively correlated (r \u20130.59,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value 0.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case series investigating the changes in osmolality alongside pre-perfusion reduced urine output and post-perfusion a state of polyuria, is our primer for a future assay-based objective study. We have created a framework of concepts that provide clarity to the dynamics of ADH-release in OPCABG patients. Furthermore, we are presenting a different hypothesis to explain increase in ADH-release that is evidence-based and open to critical comments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_294_25","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:00:15Z","timestamp":1791824415000},"page":"600-604","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Anti-Diuretic Hormone Dynamics in Off pump Coronary Artery Bypass Grafting (OPCABG) Patients: A Case Series"],"prefix":"10.4103","volume":"29","author":[{"given":"Anity Singh","family":"Dhanyee","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Mahatma Gandhi Medical College and Research Institute, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Sivashanmugam","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Harini","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V R Hemanth","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Ananthkumar","sequence":"additional","affiliation":[{"name":"Department of CTVS, Mahatma Gandhi Medical College and Research Institute, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"R1-20261014","first-page":"99","article-title":"Temporary diabetes insipidus in 2 men after on-pump coronary artery bypass grafting","volume":"40","author":"Uyar","year":"2013","journal-title":"Tex Heart Inst J"},{"key":"R2-20261014","doi-asserted-by":"crossref","first-page":"523","DOI":"10.5005\/jp-journals-10071-23278","article-title":"Central diabetes insipidus in an off-pump coronary artery bypass grafting surgery","volume":"23","author":"Nasa","year":"2019","journal-title":"Indian J Crit Care Med"},{"key":"R3-20261014","first-page":"P20","article-title":"Perioperative fluid and electrolyte management in cardiac surgery: A review","volume":"44","author":"Young","year":"2012","journal-title":"J Extra Corpor Technol"},{"key":"R4-20261014","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/j.jcrc.2013.05.017","article-title":"Body salt and water balances in cardiothoracic surgery patients with intensive care unit\u2013acquired hyponatremia","volume":"28","author":"Stieglmair","year":"2013","journal-title":"J Crit Care"},{"key":"R5-20261014","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s11102-020-01083-7","article-title":"Postoperative diabetes insipidus: How to define and grade this complication?","volume":"24","author":"Verstegen","year":"2021","journal-title":"Pituitary"},{"key":"R6-20261014","article-title":"Physiology, vasopressin","author":"Cuzzo","year":"2023","journal-title":"In StatPearls. 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