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Hyponatremic Encephalopathy
- Hyponatremic encephalopathy is a true emergency and due to hypoosmolar-induced cerebral edema.
- In contrast to the asymptomatic patient with hyponatremia, treatment of hyponatremic encephalopathy is determined by symptoms and not the duration of hyponatremia.
- Clinical manifestations include nausea, vomiting, headache, confusion, seizures, respiratory failure, and coma.
- Hypertonic saliine is the treatment of choice
- Administer 2 ml/kg 3% hypertonic saline (100 ml in many cases)
- This will typically raise serum sodium 2 mEq/L
- In most cases, a 4-6 mEq/L rise will reverse neurologic symptoms
References
Archinger SG, Ayus JC. Treatment of hyponatremic encephalopathy in the critically ill. Crit Care Med. 2017; epub ahead of print.