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


  • Dosing poorly described
  • Ranges from 0.5-2 mcg every 8-12 hours
  • Titrate to urine output and sodium response

Prognosis After CPM


  • Hyponatremia requires careful physiologic understanding to assess etiology
  • Successful treatment varies widely by etiology
  • Overcorrection can lead to substantial, delayed, irreversible neurologic dysfunction