Treatment of Symptomatic Hyponatremia and Its Relation to Brain Damage

Abstract

We studied the effects of replacement therapy in two groups of patients with symptomatic hyponatremia. Thirty-three patients, who were studied prospectively, had no evidence of cerebral demyelinating lesions. Their hyponatremia (mean serum sodium concentration [±SE], 108±1 mmol per liter) was increased to 126±1 mmol per liter with hypertonic saline (856 mM) delivered at a rate of 1.3±0.2 mmol per liter per hour. The serum sodium concentration did not rise to normal or hypernatremic levels in the first 48 hours of therapy, and none of these patients had a respiratory arrest or other hypoxic episode.