What are the guidelines regarding treatment of symptomatic patients with acute hyponatremia?

Updated: Jun 17, 2019
  • Author: Eric E Simon, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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A panel of United States experts on hyponatremia issued guidelines on the diagnosis, evaluation, and treatment of hyponatremia in 2007; the guidelines were updated in 2013. [34] For treatment of symptomatic patients with acute hyponatremia (ie, with a known duration of < 24-48 hours), the panel recommended urgent correction by 4-6 mmol/L to prevent brain herniation and neurological damage from cerebral ischemia. Recommended treatment of acute hyponatremia varies by symptom severity, as follows:

  • Severe symptoms: 100 mL of 3% NaCl infused intravenously over 10 minutes × 3 as needed
  • Mild to moderate symptoms, in patients at low risk for herniation: 3% NaCl infused at 0.5–2 mL/kg/h

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