Point‐of‐care ultrasound is a useful adjunct tool to a clinician's assessment in the evaluation of severe hyponatraemia
Authors' conclusion
As subjective clinical and biochemistry assessments of fluid status are often unreliable due to co-morbidities and concurrent use of medications, POCUS can be a rapid objective diagnostic tool to assess fluid status in patients with severe hyponatraemia, to guide accurate emergency fluid management.
Study context
- Population
- Patients with severe hyponatraemia (serum Na <120 mmol/L) managed by standard care
- Participants
- 19 patients
- Comparison
- Point-of-care ultrasound (POCUS) vs clinician assessment of fluid status, against final diagnosis at discharge
- Outcome
- Agreement of fluid status assessment (hypovolaemia, hypervolaemia or euvolaemia) with final diagnosis at discharge by retrospective case review
Performance
As reported in the abstract
Agreement with final diagnosis of fluid status
P = 0.1611
Further findings
Serum Na · admission
- Median Na on admission (mmol/L)
- 113 (109-116)
- Na on discharge (mmol/L)
- 129 ± 3
Unreliable biochemistry
- Biochemistry unreliable, likely due to renal failure, polypharmacy or diuretic use
- 58% (n = 11/19)
Thirst and hypovolaemia
- Thirst symptom correlated to hypovolaemia
- 80% (4/5)
Safety
Inappropriate emergency fluid management based on initial clinician assessment
- Inappropriate emergency fluid management
- 37% (n = 7/19)
Original publication
Point‐of‐care ultrasound is a useful adjunct tool to a clinician's assessment in the evaluation of severe hyponatraemia. Clin Endocrinol (Oxf). Published 16 January 2024. doi:10.
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