Boluses of Hypertonic Saline Resulted in More-Rapid Correction in Symptomatic Hyponatremia

Acute symptomatic hyponatremia is a medical emergency that requires rapid intervention. Although serum sodium levels must be increased acutely to avoid progressive brain edema and potential herniation, too-rapid correction can cause osmotic demyelination.

Irish investigators examined two cohorts of patients: 22 patients had hyponatremia corrected with bolus infusions of 3% saline, and 28 received continuous infusion of 3% saline. All patients had received diagnoses of syndrome of inappropriate antidiuresis (SIAD), with sodium levels <125 mmol/L and neurological symptoms. Bolus treatment resulted in more-rapid sodium correction in the first 6 and 12 hours; no difference between treatments was observed at 24 hours. Glasgow Coma Scale (GCS) imp…