Document Type
Article
Publication Date
2013
Abstract
Hyponatremia represents a serious health hazard.1 Hospitalized patients,2 nursing home residents,3 women,4,5 and children6 exhibit high frequency and/or severity of hyponatremia. Hyponatremia developing during the course of other morbid conditions increases their severity.7–10 Estimates of direct costs for treating hyponatremia in the United States ranged between $1.61 and $3.6 billion.11
Clinical manifestations of hyponatremia are universal12,13 and range from subtle (disturbances of balance, problems in cognition detected only during specific testing) to life-threatening manifestations of increased intracranial pressure with life-threatening hypoxia14–16 and noncardiac pulmonary edema.17 Although the treating physicians must make an accurate diagnosis based on well-established and described clinical criteria,1 treatment is also guided by the severity of these manifestations. The magnitude and rate of increase in serum sodium concentration ([Na]) during treatment are critical. Overcorrection of chronic hyponatremia may lead to osmotic myelinolysis,18–21 whereas undercorrection may fail to prevent life-threatening manifestations.1,22
Recommended Citation
Tzamaloukas AH, Malhotra D, Rosen BH, Raj DS, Murata GH, and Shapiro JI. Principles of management of severe hyponatremia. J Am Heart Assoc. 2013; 2: e005199. doi: 10.1161/JAHA.112.005199
Comments
The copy of record is available from the publisher at http://www.jaha.ahajournals.org/content/2/1/e005199.full.pdf. Copyright © 2013 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley-Blackwell. This is an Open Access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.