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Management of symptomatic hyponatraemia: dependence on the duration of development
Author(s) -
HÖJER J.
Publication year - 1994
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1994.tb01110.x
Subject(s) - medicine , furosemide , hyponatremia , coma (optics) , sodium , electrolyte disorder , anesthesia , gastroenterology , chemistry , physics , organic chemistry , optics
. Serious neurological symptoms are common in patients with a serum sodium concentration below 115 mmol l ‐1 . The treatment is controversial and the most adequate rate of sodium correction to avoid both morbidity due to residual hypo‐osmolality and therapy‐induced neurological sequelae is debated. The management of symptomatic hyponatraemia is discussed here against the background of two cases and a literature review. It is concluded that the treatment should be based on whether the electrolyte disturbance is acute (< 24–36 h) or has developed insidiously. Slow sodium correction (< 0.5 mmol l ‐1 h ‐1 ) in patients with chronic hyponatraemia and rapid correction (1–2 mmol l ‐1 h ‐1 ) to a moderately hyponatraemic level in those with an acute development are recommended. If available data do not permit differentiation between the two conditions in a patient with seizures or in coma, rapid correction with sodium chloride and furosemide for 3–4 h followed by slow correction therapy is suggested.