Challenges in the acute management of profound hyponatraemia presenting with severe symptoms.
Hosp Pract (1995). 2016 Sep 6;
Authors: Mamoojee Y, Mukhtar R
Abstract
Currently available guidelines in the acute management of severely symptomatic hypotonic hyponatraemia vary in their approach to the use of hypertonic saline. In the acute setting, deciding on when to implement available treatment algorithm using hypertonic saline may be difficult, given that the duration of hyponatraemia and potential alternative diagnoses presenting with similar symptoms may be hard to establish promptly. We present the case of a young female with symptomatic profound hyponatraemia who subsequently developed osmotic demyelination syndrome due to rapid overcorrection of serum sodium concentration. We discuss the interplay between the dynamic pathophysiological processes responsible for hypotonic hyponatraemia in adrenal insufficiency and conduct a detailed analysis of currently available guidelines to highlight the challenges in acute and reactive treatment in clinical practice.
PMID: 27598428 [PubMed - as supplied by publisher]