Hypertonic Saline for HypoNatremia and Sounding

Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

A. Terry -

Good discussion. In the last few weeks, had a patient with underlying seizure disorder, presented with seizure that resolved after a couple minutes prior to arrival, and back to baseline throughout ED stay. Sodium was 116. I thought at 116 it was unlikely strictly due to the sodium and more likely related to underlying seizure disorder, neurology agreed, and didn't give it. Curious to see if others are in agreement or will skewer me for not giving it.

And the whole sounding thing...horrifying.

Alfredo T., MD -

You overlooked two important points:

1. You did not differentiate between acute and chronic hyponatremia. Acute hyponatremia may need to be treated rapidly with hypertonic saline, even if the patient has no symptoms,yet.

2. Hypertonic saline does not cause central pontine myelonysis; it is caused by too rapid correction of chronic (not acute!) hyponatremia, by any method of correction.

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
Hypertonic Saline for HypoNatremia and Sounding: A Board Review Short Full episode audio for MD edition 7:23 min - 6 MB - M4A