Observational studyEuropean journal of endocrinology2021
Treatment of symptomatic hyponatremia with hypertonic saline: a real-life observational study.
Observational study in European journal of endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Safety of peripheral intravenous administration of hypertonic saline: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Overcorrection of Hyponatremia: A Complicated Story.Electrolyte & blood pressure : E & BP · 2026Review
- Clinical factors associated with hyponatremia correction during treatment with oral urea.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Article
- Correction of profound hyponatraemia following rapid bolus therapy: effectiveness of the Barsoum-Levine formula based on the Edelman equation.Clinical kidney journal · 2025Article
- [Consensus recommendations on the diagnosis and treatment of hyponatremia from the Austrian Society for Nephrology 2024].Wiener klinische Wochenschrift · 2024Article
- Letter to Editor: Call for review of European Society of Endocrinology guidelines for symptomatic hyponatraemia.Endocrine · 2023Article
- Disorders of Salt and Water Balance After Pituitary Surgery.The Journal of clinical endocrinology and metabolism · 2022Article
- Administration of 3% Sodium Chloride and Local Infusion Reactions.Children (Basel, Switzerland) · 2022Article
- Approach to the Patient: Hyponatremia and the Syndrome of Inappropriate Antidiuresis (SIAD).The Journal of clinical endocrinology and metabolism · 2022Review
- Hypertonic Saline for Hyponatremia: Meeting Goals and Avoiding Harm.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Article
- Hypertonic saline for severe symptomatic hyponatraemia: real-world findings from the UK.Endocrine connections · 2022Article
- Treatment of hyponatremia in children with acute bacterial meningitis.Frontiers in neurology · 2022Article
- The management of acute and chronic hyponatraemia.Therapeutic advances in endocrinology and metabolism · 2022Review
- Management of SIADH-related hyponatremia due to psychotropic medications - An expert consensus from the Association of Medicine and Psychiatry.Journal of psychosomatic research · 2021Article
- [Hypo- and hypernatremia in the intensive care unit : Pitfalls in volume management].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2021Review
- Edelman Revisited: Concepts, Achievements, and Challenges.Frontiers in medicine · 2021Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTreatment of symptomatic hyponatremia is not well established. The European guidelines recommend bolus-wise administration of 150 mL of 3% hypertonic saline. This recommendation is, however, based on low level of evidence.
designObservational study.
methodsSixty-two consecutive hyponatremic patients admitted to the emergency department or intensive care unit of the University Hospital Wuerzburg were divided in subgroups according to treatment (150 mL bolus of 3% hypertonic saline or conventional treatment) and symptom severity. Treatment target was defined as an increase in serum sodium by 5-10 mEq/L within first 24 h and maximum 8 mEq/L during subsequent 24 h.
resultsThirty-three out of sixty-two patients (53%) were presented with moderate symptoms and 29/62 (47%) with severe symptoms. Thirty-six were treated with hypertonic saline and 26 conventionally. In the hypertonic saline group, serum sodium increased from 116 ± 7 to 123 ± 6 (24 h) and 127 ± 6 mEq/L (48 h) and from 121 ± 6 to 126 ± 5 and 129 ± 4 mEq/L in the conventional group, respectively. Overcorrection at 24 h occurred more frequent in patients with severe symptoms than with moderate symptoms (38% vs 6%, P < 0.05). Diuresis correlated positively with the degree of sodium overcorrection at 24 h (r = 0.6, P < 0.01). Conventional therapies exposed patients to higher degrees of sodium fluctuations and an increased risk for insufficient sodium correction at 24 h compared to hypertonic saline (RR: 2.8, 95% CI: 1.4-5.5).
conclusionSodium increase was more constant with hypertonic saline, but overcorrection rate was high, especially in severely symptomatic patients. Reducing bolus-volume and reevaluation before repeating bolus infusion might prevent overcorrection. Symptoms caused by hypovolemia can be misinterpreted as severely symptomatic hyponatremia and diuresis should be monitored.
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