Rethinking Slow Sodium Correction of Severe Hyponatremia

Clinical guidelines recommend slow correction of severe hyponatremia to avoid osmotic demyelination syndrome (ODS). However, recent studies have demonstrated that slower sodium correction rates are associated with higher short-term mortality and that ODS is rare and can occur regardless of odium correction rates. To address this further, researchers retrospectively studied 14,000 hospitalized adults with severe hyponatremia (serum sodium, ≤120 mEq/L) from a health care system with 21 community-based California hospitals. Rates of 24-hour correction were categorized as slow (<8 mEq/L), medium (8–12 mEq/L), or fast (>12 mEq/L).