{
  "abstract": "Objective(s):: 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.\n\nDesign; Setting; Participants; Interventions:: 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.\n\nMeasurements and Main Results:: The data was systematically analyzed in terms of descriptives, paired T-test and correlation statistics. The pre-post serum osmolality was found to increase (P value 0.389, Cohen’s d –0.26) whereas urine osmolality decreased significantly (P value 0.013, Cohen’s 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 –0.59, P value 0.04).\n\nConclusion:: 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.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anaesthesia, Mahatma Gandhi Medical College and Research Institute, Puducherry, India",
    "Department of Anaesthesiology and Pain Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India",
    "Department of CTVS, Mahatma Gandhi Medical College and Research Institute, Puducherry, India"
  ],
  "article_type": "other",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Anity Singh Dhanyee"
    },
    {
      "affs": [
        1
      ],
      "name": "T Sivashanmugam"
    },
    {
      "affs": [
        1
      ],
      "name": "P Harini"
    },
    {
      "affs": [
        1
      ],
      "name": "V R Hemanth Kumar"
    },
    {
      "affs": [
        2
      ],
      "name": "S Ananthkumar"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fyj8ze8ysn99m.bib",
  "cited_by": 0,
  "doi": "10.4103/aca.aca_294_25",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13743089/",
  "id": "fyj8ze8ysn99m",
  "issns": [
    "0971-9784",
    "0974-5181"
  ],
  "landing_url": "https://doi.org/10.4103/aca.aca_294_25",
  "language": "en",
  "licence": "CC-BY-NC-SA-4.0",
  "licence_label": "CC BY-NC-SA 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Brief Communication"
    ],
    [
      "openalex",
      "2727|Electrolyte and hormonal disorders"
    ]
  ],
  "openalex": "W7221540331",
  "pdf_url": null,
  "pmcid": "PMC13743089",
  "pmid": "42862677",
  "published": "2026-10-12",
  "publisher": "Wolters Kluwer -- Medknow Publications",
  "ris": "https://research.draconitic.com/paper/fyj8ze8ysn99m.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T12:23:48Z",
      "native_id": "PMC13743089",
      "source": "pmc",
      "url": "https://doi.org/10.4103/aca.aca_294_25"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Electrolyte and hormonal disorders",
      "subfield": "general"
    }
  ],
  "title": "Understanding Anti-Diuretic Hormone Dynamics in Off pump Coronary Artery Bypass Grafting (OPCABG) Patients: A Case Series",
  "title_text": "Understanding Anti-Diuretic Hormone Dynamics in Off pump Coronary Artery Bypass Grafting (OPCABG) Patients: A Case Series",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T12:23:48Z",
  "url": "https://research.draconitic.com/paper/fyj8ze8ysn99m",
  "venue": "Annals of Cardiac Anaesthesia",
  "versions": []
}