Relower sodium
12-16 mEq/L lower than initial sodium over 48 hours
Electrolyte-Free Free Water
- IV D5W or enteral free water
- 3 mL/kg change in body water will change Na+ by 1 mEq/L
Desmopressin
- Dosing poorly described
- Ranges from 0.5-2 mcg every 8-12 hours
- Titrate to urine output and sodium response
Prognosis After CPM
Conclusion
- Hyponatremia requires careful physiologic understanding to assess etiology
- Successful treatment varies widely by etiology
- Overcorrection can lead to substantial, delayed, irreversible neurologic dysfunction