Hyponatremia by definition is described as serum Na <135 meq/l and severe hyponatremia is sodium levels less than 120meq/l. It is seen up to ~30% of patients in ICU settings 1-3.
On this page:
Clinical presentation
Development of symptoms in less than 48 hours is called acute hyponatremia, resulting in fits, impaired sensorium, acute psychosis, permanent brain damage, brainstem herniation, cerebral edema and coma 2,4.
Hyponatremia that persists more than 48 hours is called chronic hyponatremia; most of the patients are asymptomatic. Possible symptoms include recurrent falls, gait disturbances, and gastric symptoms, including nausea, vomiting, and loss of appetite 2-4.
Pathology
It is commonly caused by the inability of the renal system to excrete water load or secondary to excess plain water intake. Increased aquaporin expression secondary to increased antidiuretic hormone (vasopressin) secretion from the posterior pituitary will lead to increased thirst 1.
Treatment and prognosis
In patients with symptomatic and acute hyponatremia, a guideline of therapy is a bolus of hypertonic saline. Fluid restriction is recommended in cases of chronic hyponatremia 2,3.
Unable to process the form. Check for errors and try again.