This paper is only available as a PDF. To read, Please Download here.
Abstract
Severe hyponatremia with hypoosmolality carries a high morbidity and mortality and
constitutes a life-threatening emergency. We report seven cases of severe hyponatremia
(serum sodium concentration 99.7 ± 3.0 meq/liter) (mean ± SEM) with hypoosmolality
(212 ± 8 mOsm/kg water) that presented with severe neurologic complications. Serum
sodium concentration was corrected in 13.3 ± 2.2 hours to mildly hyponatremic levels
(serum sodium concentration 128.3 ± 1.6 meq/liter). The rate of correction of serum
sodium concentration was 2.4 ± 0.5 meq/liter/hr. This was achieved by the intravenous
administration of 3 percent hypertonic saline solution (687 ± 43 meq sodium chloride)
and furosemide or by hemodialysis where indicated. No complications occurred from
treatment and all of our patients recovered without neurologic sequelae. Early diagnosis
and rapid correction of serum sodium concentration appear to reduce the significant
morbidity and mortality of severe hyponatremia.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Neurological manifestations and morbidity of hyponatremia: correlation with brain water and electrolytes.Medicine (Baltimore). 1976; 55: 121-129
- Disorders of sodium and water metabolism and their effects on the central nervous system.in: Brenner BM Stein JH Sodium and water homeostasis. Churchill Livingston, 1978: 212-241
- Central pontine myelinolysis: an osmotic gradient pathogenesis (abstract).J Neuropathol Exp Neurol. 1980; 39: 370
- Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis.Science. 1981; 211: 1068-1070
- Rapid correction of hyponatremia in the syndrome of inappropriate secretion of antidiuretic hormone. An alternative treatment to hypertonic saline.Ann Intern Med. 1973; 78: 870-875
- Metabolic disturbance due to villous papilloma of the rectum.Br J Surg. 1959; 47: 177-178
- Inappropriate antidiuretic hormone secretion.J So Carolina Med Assoc. 1966; 62: 455-460
- Psychogenic water intoxication.Am J Psychiat. 1972; 129: 628-630
- Thiazide-induced hyponatremia associated with death or neurologic damage in out-patients.Am J Med. 1981; 70: 1163-1168
- Death or permanent neurological disability despite correction of protracted hyponatremia (abstract).Kidney Int. 1979; 16: 955
- Central pontine myelinolysis.Q J Med. 1976; 45: 373-386
- Effect of furosemide on free water excretion in edematous patients with hyponatremia.Kidney Int. 1973; 3: 30-34
Article info
Publication history
Accepted:
September 28,
1981
Identification
Copyright
© 1982 Published by Elsevier Inc.
