EMCrit 402 – Sea Change on Salt Water (More Rapid Sodium Normalization in Hyponatremia)? with KidneyBoy

• New systematic review found that patient’s had worse outcomes with slow correction
  • Comparative studies assessing
    • rapid (≥8-10 mEq/L per 24 hours) vs
    • slow (<8 or 6-10 mEq/L per 24 hours) and
    • very slow (<4-6 mEq/L per 24 hours) correction of severe hyponatremia (serum sodium <120 mEq/L or <125 mEq/L plus severe symptoms) in hospitalized patients.
  • Slow correction and very slow correction of severe hyponatremia were associated with an increased risk of mortality and hospital LOS compared to rapid correction.
  • Rapid correction was not associated with a statistically significant increased risk of ODS.

• 2 Approaches offered in the post:

OR

Uptodate’s algorithm is easiest to follow: