Abstract |
Hypertonic NaCl is first-line therapy for acute, severe and symptomatic hyponatremia; however, its use is often restricted to the intensive care unit (ICU). A 35-year-old female inpatient with an optic chiasm glioma and ventriculoperitoneal shunt for hydrocephalus developed acute hyponatremia ( sodium 122 mEq/l) perhaps coinciding with haloperidol treatment. The sum of her urinary sodium and potassium concentrations was markedly hypertonic vis-à-vis plasma; it was inferred that serum sodium concentration would continue to fall even in the complete absence of fluid intake. Intravenous (i.v.) 3% NaCl was recommended; however, a city-wide public health emergency precluded her transfer to the ICU. She was treated with hourly oral NaCl tablets in a dose calculated to deliver the equivalent of 0.5 ml/kg/h of 3% NaCl with an objective of increasing the serum sodium concentration by 6 mEq/l. She experienced a graded and predictable increase in serum sodium concentration. A slight overshoot to 129 mEq/l was rapidly corrected with 0.25 l of D5W, and she stabilized at 127 mEq/l. We conclude that hourly oral NaCl, in conjunction with careful monitoring of the serum sodium concentration, may provide an attractive alternative to i.v. 3% NaCl for selected patients with severe hyponatremia.
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Authors | Eric Kerns, Shweta Patel, David M Cohen |
Journal | Clinical nephrology
(Clin Nephrol)
Vol. 82
Issue 6
Pg. 397-401
(Dec 2014)
ISSN: 0301-0430 [Print] Germany |
PMID | 23816479
(Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
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Chemical References |
- Anti-Anxiety Agents
- Tablets
- Sodium Chloride
- Sodium
- Haloperidol
- Potassium
|
Topics |
- Administration, Oral
- Adult
- Anti-Anxiety Agents
(therapeutic use)
- Female
- Haloperidol
(therapeutic use)
- Humans
- Hydrocephalus
(therapy)
- Hyponatremia
(drug therapy)
- Optic Chiasm
(pathology)
- Optic Nerve Glioma
(complications)
- Potassium
(blood)
- Sodium
(blood)
- Sodium Chloride
(administration & dosage, therapeutic use)
- Tablets
- Ventriculoperitoneal Shunt
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