Observational studyClinical journal of the American Society of Nephrology : CJASN2014
Use of desmopressin acetate in severe hyponatremia in the intensive care unit.
Observational study in Clinical journal of the American Society of Nephrology : CJASN, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Safety and efficacy of desmopressin (DDAVP) in preventing hematoma expansion in intracranial hemorrhage associated with antiplatelet drugs use: A systematic review and metaanalysis.Brain and behavior · 2024Pooled it
- Criteria for Hyponatremic Overcorrection: Systematic Review and Cohort Study of Emergently Ill Patients.Journal of general internal medicine · 2020Pooled it
- Safety and efficacy of proactive versus reactive administration of desmopressin in severe symptomatic hyponatremia: a randomized controlled trial.Scientific reports · 2024Trial
- Severe Hyponatremia From Lupus-Related Syndrome of Inappropriate Antidiuresis (SIADH): A Diagnostic Challenge.Cureus · 2025Article
- Exercise-associated Hyponatremia Developing Immediately after a Musical Stage Performance in a Healthy Actress.Internal medicine (Tokyo, Japan) · 2025Article
- Hyponatremia Correction and Osmotic Demyelination Syndrome Risk: A Systematic Review and Meta-Analysis.Kidney medicine · 2025Article
- The risk of sodium overcorrections in severe hyponatremia and the utility of desmopressin: a large retrospective study.Clinical kidney journal · 2025Article
- [Consensus recommendations on the diagnosis and treatment of hyponatremia from the Austrian Society for Nephrology 2024].Wiener klinische Wochenschrift · 2024Article
- Transient severe hypotonic hyponatraemia in children - presentation of three cases.Pediatric endocrinology, diabetes, and metabolism · 2024Article
- Syndrome of Inappropriate Antidiuresis: From Pathophysiology to Management.Endocrine reviews · 2023Review
- Hypertonic Saline for Hyponatremia: Meeting Goals and Avoiding Harm.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Article
- Hyponatremia management among patients admitted to tertiary hospital: A retrospective evaluation.SAGE open medicine · 2022Article
- Role of Risk Factors in Developing Osmotic Demyelination Syndrome During Correction of Hyponatremia: A Case Study.Cureus · 2020Article
- Osmotic demyelination syndrome in a patient with Noonan syndrome and anterior hypopituitarism.Endocrinology, diabetes & metabolism case reports · 2020Article
- Treatment of severe symptomatic hyponatremia.Physiological reports · 2019Article
- Misconceptions and Barriers to the Use of Hypertonic Saline to Treat Hyponatremic Encephalopathy.Frontiers in medicine · 2019Review
- The Role of Desmopressin in the Management of Severe, Hypovolemic Hyponatremia: A Single-Center, Comparative Analysis.Canadian journal of kidney health and disease · 2018Article
- A low initial serum sodium level is associated with an increased risk of overcorrection in patients with chronic profound hyponatremia: a retrospective cohort analysis.BMC nephrology · 2017Observational
- Long-term changes in dysnatremia incidence in the ICU: a shift from hyponatremia to hypernatremia.Annals of intensive care · 2016Article
- Clinical aspects of symptomatic hyponatremia.Endocrine connections · 2016Review
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesExcessive correction of chronic and profound hyponatremia may result in central pontine myelinolysis and cause permanent brain damage. In the case of foreseeable or established hyponatremia overcorrection, slowing down the correction rate of sodium plasma levels (PNa) or reinducing mild hyponatremia may prevent this neurologic complication. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This retrospective and observational study was performed with 20 consecutive patients admitted to two intensive care units for severe hyponatremia, defined by PNa <120 mmol/L and/or neurologic complications ascribable to hyponatremia and subsequently treated by desmopressin acetate (DDAVP) during correction of hyponatremia when the rate of correction was overtly or predictably excessive. The primary endpoint was the effectiveness of DDAVP on PNa control.
resultsDDAVP dramatically decreased the rate of PNa correction (median 0.81 mmol/L per hour [interquartile range, 0.46, 1.48] versus -0.02 mmol/L per hour [-0.16, 0.22] before and after DDAVP, respectively; P<0.001) along with a concurrent decrease in urine output (650 ml/h [214, 1200] versus 93.5 ml/h [43, 143]; P=0.003), and a rise in urine osmolarity (86 mmol/L [66, 180] versus 209 mmol/L [149, 318]; P=0.002). The maximal magnitude of PNa variations was also markedly reduced after DDAVP administration (11.5 mmol/L [8.25, 14.5] versus 5 mmol/L [4, 6.75]; P<0.001). No patient developed seizures after DDAVP or after subsequent relowering of PNa that occurred in 11 patients.
conclusionsDesmopressin acetate is effective in curbing the rise of PNa in patients admitted in the intensive care unit for severe hyponatremia, when the initial rate of correction is excessive.
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Registered trials
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