Title: Hyponatremia in the Brain Injured Patient<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<strong><u>Hyponatremia in the Brain Injured Patient</u></strong></p>
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Hyponatremia is the most common electrolyte disorder in neurocritical care and is associated with increased ICP.</li>
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The two most common causes of hyponatremia in this patient population are cerebral salt wasting syndrome and SIADH.</li>
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Symptomatic hyponatremia should be treated with hypertonic saline:
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30-45 ml of 10% NaCl <em>or</em></li>
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100-150 ml of 3% NaCl</li>
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In order to prevent osmotic demyelination syndrome (ODM), sodium should not be corrected by more than 10 mmol/L/day.</li>
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The risk of ODM is low when acute hyponatremia develops in less than 48 hours.</li>
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<fieldset><legend>References</legend>
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Mrozek S, et al. Pharmacotherapy of sodium disorders in neurocritical care. <em>Curr Opin Crit Care</em>. 2019; 25:132-7.</p>
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