NaCl 3% Bolus Therapy as Emergency Treatment for Severe Hyponatremia: Comparison of 100 mL vs 250 mL
Authors' conclusion
Initial treatment of severe hypotonic hyponatremia is more effective with a NaCl 3% bolus of 250 mL than of 100 mL and does not increase the risk of overcorrection.
Study context
- Population
- Adults with severe hypotonic hyponatremia (serum sodium ≤ 120 mmol/L) admitted to a teaching hospital in The Netherlands, 2017–2019
- Participants
- 130 adults
- Exposure
- NaCl 3% bolus 250 mL vs 100 mL
- 250 mLn = 67
- 100 mLn = 63reference
- Outcome
- Successful treatment: rise in serum sodium ≥ 5 mmol/L
- Follow-up
- Within the first 4 hours after bolus therapy
Methodological detailssingle teaching hospital
- Single teaching hospital
Main finding
As reported in the abstract
Rise in serum sodium ≥5 mmol/L · within 4 hours
P = 0.018
Observational data: associations, not effects.
Safety
Overcorrection of serum sodium (increase >10 mmol/L in first 24 hours) · median 13 hours (range 9-17 hours)
P = 0.971
Osmotic demyelination syndrome
- Osmotic demyelination syndrome did not occur
Original publication
NaCl 3% Bolus Therapy as Emergency Treatment for Severe Hyponatremia: Comparison of 100 mL vs 250 mL. J Clin Endocrinol Metab. Published 20 February 2023. doi:10.
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