II. Pathophysiology
- Lethal Cerebral edema from rapid Electrolyte correction
- Over-correction of Serum Sodium
- Too rapid correction of Serum Sodium
- Related to chronicity of Electrolyte disturbance
- Associated with rapid Sodium correction in chronic Hyponatremia (present >48 hours)
- Not associated with correction of acute Hyponatremia (esp. <24 hours)
- Severe symptomatic Hyponatremia (esp. <120 mEq/L) requires rapid Sodium replacement
III. Prevention
- In chronic Hyponatremia, do not correct Sodium >0.5 mEq/h or >12 mEq/day
- Some recommend limiting daily maximum correction to 6 mEq/day
IV. References
- Le and Drogell (2015) Crit Dec Emerg Med 29(11): 13-19