What Are the Best Methods for Hyponatremia Management?

Hyponatremia management is often targeted towards elimination of the cause. Once the cause has been removed, the correction of hyponatremia will be appropriate an efficient. Another way to know how to manage hyponatremia is to establish if the condition is either acute (quick development spanning only a few days to a couple of weeks) or chronic (condition has developed over several days, weeks, spanning to more than 6 months).

Conservative hyponatremia management is recommended if the patient has mild symptoms such as headache, lethargy, and dizziness, if patient is asymptomatic, or if serum sodium level is less than 135 mEq/L, but it is greater than 125 mEq/L. If hyponatremia is brought about by any medications, the drug should be discontinued if possible. However, tapering is advised if the drug in question in an anti-depressant or a corticosteroid. In some conditions, restriction of free water may be recommended. The patient must only consume 1-1.25 liters of water per day depending on the severity of hyponatremia.

Hyponatremia management of hypertonic IV infusion is done in other cases if serum sodium levels continue to stay below normal level or if it still continues to drop. Sodium correction should be done with caution for there is risk of osmotic demyelination syndrome, or brain herniation. Both conditions can result to sever brain injury and even death in some cases.

Generally, hyponatremia management should be an hourly increase of serum sodium levels of no greater than 0.5 mEq/L. Severe symptoms require rapid management within the first two hours to prevent risk of hyponatremia. Correction should be aimed at increasing serum sodium levels to no 12 mEq/L in the first 12-16 hours or at a rate of 0.5-1.0 mEq/L. A hypertonic solution of3% saline is used for this purpose, or a solution of 5 mEq/10 ml. Solution is generally infused at a rate of 25 mL/h, which will correct serum sodium levels by 10 mEq/L in the first day.

Medications can be used if patient has problems adhering to fluid restriction during hyponatremia management. Demecocycline (Declomycin) given in 600-1,200 mg daily can be used to induce nephrogenic diabetes insipidus. Caution is advised when using this medication in patients with liver or kidney problems. Arginie vasopressin receptor antagonists can also help correct hyponatremia by targeting the renal tubules to retain sodium and eliminate water.

In all hyponatremia management applications, regular monitoring of serum sodium levels are necessary to establish effectiveness of the therapy and also to prevent over-correction of hyponatremia.