Hyponatremia in the intensive care unit: How to avoid a Zugzwang situation?

15Citations
Citations of this article
98Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Hyponatremia is a common electrolyte derangement in the setting of the intensive care unit. Life-threatening neurological complications may arise not only in case of a severe (<120 mmol/L) and acute fall of plasma sodium levels, but may also stem from overly rapid correction of hyponatremia. Additionally, even mild hyponatremia carries a poor short-term and long-term prognosis across a wide range of conditions. Its multifaceted and intricate physiopathology may seem deterring at first glance, yet a careful multi-step diagnostic approach may easily unravel the underlying mechanisms and enable physicians to adopt the adequate measures at the patient’s bedside. Unless hyponatremia is associated with obvious extracellular fluid volume increase such as in heart failure or cirrhosis, hypertonic saline therapy is the cornerstone of the therapeutic of profound or severely symptomatic hyponatremia. When overcorrection of hyponatremia occurs, recent data indicate that re-lowering of plasma sodium levels through the infusion of hypotonic fluids and the cautious use of desmopressin acetate represent a reasonable strategy. New therapeutic options have recently emerged, foremost among these being vaptans, but their use in the setting of the intensive care unit remains to be clarified.

Cite

CITATION STYLE

APA

Rafat, C., Flamant, M., Gaudry, S., Vidal-Petiot, E., Ricard, J. D., & Dreyfuss, D. (2015). Hyponatremia in the intensive care unit: How to avoid a Zugzwang situation? Annals of Intensive Care, 5(1), 1–27. https://doi.org/10.1186/s13613-015-0066-8

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free