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Review
. 2013 Jan 23;2(1):e005199.
doi: 10.1161/JAHA.112.005199.

Principles of management of severe hyponatremia

Antonios H Tzamaloukas  1 , Deepak Malhotra, Bradley H Rosen, Dominic S C Raj, Glen H Murata, Joseph I Shapiro
Affiliations
Review

Principles of management of severe hyponatremia

Antonios H Tzamaloukas et al. J Am Heart Assoc. .

Erratum in

  • J Am Heart Assoc. 2013 Aug;2(4):e000240
No abstract available

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Figures

Figure 1.
Figure 1.
Clinical approach to hyponatremia shown as a flow diagram after initial presentation. Note that the authors recommend making an initial diagnosis and choice of therapy within 2 to 3 hours after presentation with careful monitoring and therapeutic adjustments made thereafter.
Figure 2.
Figure 2.
Magenetic resonance imaging brain slice from index patient showing myelinolysis in pons (white arrow).
Figure 3.
Figure 3.
Serum sodium concentration changes ([Na]) after infusion of 1.75 L of saline with varying sodium concentration in a patient with initial body water of 26 L and initial [Na] of 111 mEq/L. The changes in [Na] were computed by formula 7 of this report.
Figure 4.
Figure 4.
Effect of varying body water estimates on the change in serum sodium concentration of a patient with initial serum sodium concentration ([Na]) of 111 mEq/L infused with various volumes of 0.154 mol/L saline. Calculations from formula 7 (Table 3).
Figure 5.
Figure 5.
Effect of urine composition ([Na]U+[K]U) and flow rate on serum sodium concentration [Na] after infusion of 1.75 L of 0.154 mol/L saline in a patient with initial body water of 26 L and [Na] of 111 mEq/L calculated from formula 9 (Table 3) if all the other influences depicted in this formula except urinary losses result in an [Na] of 116.0 mEq/L (Table 5). At [Na]U+[K]U=116 mEq/L, urinary losses have no effect on [Na]. [Na] decreases if [Na]U+[K]U >116 mEq/L and increases if [Na]U+[K]U <116 mEq/L.
See this image and copyright information in PMC

References

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