Janka
Forum Senior
Topics: 28
Posts: 146
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hi guys,
step2 secrets says one should almost never use hypertonic saline to correct hyponatremia because of risk of central pontine myelolysis. specifically, it says hypertonic saline is to be used only in the case of seizures and one is better off choosing normal saline in 99% of boards questions.
however, when i applied that principle to a UW question, i had to read in their explanation that hypertonic saline is the therapy of choice in the setting of acute hyponatremia where "the brain hasn't yet lost volume to accomodate the new serum concentration and correction can thus happen more rapidly".
so, i'd like to hear what you guys think of that. hypertonic saline yes/no/maybe?
thanks 
janka
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| aspire
Forum Senior
Topics: 24
Posts: 158
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I studied that hypertonic saline is the treatment when serum sodium is less than 110mEq/L.
120-130=water restriction
110-120=loop diuretics
Am I right?
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| guangyu
Forum Elite
Topics: 29
Posts: 308
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yes, from UW
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| Markus2009
Forum Senior
Topics: 9
Posts: 189
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Hypertonic saline if it is severe hyponatremia or neurologic symptoms but the correction is slowly to decrease complications.
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| farnsworth
Forum Newbie
Topics: 0
Posts: 165
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if hyponatremia occurs fast (like intra-operatively, TURP syndrome), you give loop diuretics and correct hyponatremia fast.
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