Treatment of hyponatraemic seizures with intravenous 29.2% saline.

Worthley, L. I. G.; Thomas, P

doi:10.1136/bmj.292.6514.168

Cited by 95 publications

(46 citation statements)

References 14 publications

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“…Severely symptomatic hyponatraemia is a dangerous condition, which may lead to permanent brain damage or death if left untreated (73). Although the available data stem from small series, they do suggest that the situation can be reversed by rapidly increasing the serum sodium concentration in the first hour (85,119). Given the immediate risk of severe neurological damage, reducing brain oedema should be prioritised in severely symptomatic hyponatraemia as this threat overrules that of possibly inducing osmotic demyelination or fluid overload.…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

“…Several early case series reported the use of i.v. hypertonic saline as treatment for hyponatraemia (119,120,121,122,123,124,125). However, settings, biochemical severity, rate of development, symptoms and co-interventions differed widely both between and within studies and were often difficult to assess.…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

“…If severe symptoms are caused by hyponatraemia, then small increases in effective osmolality by small increases in serum sodium concentration may be sufficient to improve them and to prevent brain stem herniation (119). The infusion of 3% hypertonic saline is an effective way to rapidly increase the serum sodium concentration.…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

“…In 1986, Worthley et al reported five patients who presented with seizures caused by acute hyponatraemia. They were treated with 250 mmol sodium chloride, infused over 10 min (119). Serum sodium concentrations increased with a mean of 7.4G1.1 mmol/l after w1 h and neurological symptoms promptly improved in all five cases.…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

See 3 more Smart Citations

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Spasovski

Vanholder

Allolio

et al. 2014

European Journal of Endocrinology

633

671

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Hyponatraemia, defined as a serum sodium concentration !135 mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution-and speciality-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association -European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed the Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. In addition to a rigorous approach to methodology and evaluation, we were keen to ensure that the document focused on patient-important outcomes and included utility for clinicians involved in everyday practice.

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Section: European Journal Of Endocrinologymentioning

confidence: 99%

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Section: European Journal Of Endocrinologymentioning

confidence: 99%

See 2 more Smart Citations

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Spasovski

Vanholder

Allolio

et al. 2014

European Journal of Endocrinology

633

671

View full text Add to dashboard Cite

show abstract

“…26 Hypertonic saline has been used successfully in the management of patients with status epilepticus induced by hyponatremia. 27 The systemic inflammatory response syndrome has been implicated in the development of both hepatic encephalopathy and IH in ALF. 28 A correlation between serial cytokine levels and the severity of hepatic encephalopathy in patients with ALF also has been found.…”

Section: Discussionmentioning

confidence: 99%

The effect of hypertonic sodium chloride on intracranial pressure in patients with acute liver failure

et al. 2004

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Acute liver failure (ALF) is a rare condition characterized by the development of encephalopathy in the absence of chronic liver disease. Cerebral edema occurs in up to 80% of patients with Grade IV encephalopathy. In the current prospective randomized controlled clinical trial, we examined the effect of induced hypernatremia on the incidence of intracranial hypertension (IH) in patients with ALF. Thirty patients with ALF and Grade III or IV encephalopathy were randomized. Patients in Group 1 (n ‫؍‬ 15) received the normal standard of care. Patients in Group 2 (n ‫؍‬ 15) received standard care and hypertonic saline (30%) via infusion to maintain serum sodium levels of 145-155 mmol/L. Intracranial pressure (ICP) was monitored in all patients with a subdural catheter (Camino Systems, San Diego, CA) for up to 72 hours after inclusion. Serum sodium levels became significantly different from the levels observed in the control group at 6 hours (P < .01). Over the first 24 hours, norepinephrine dose increased relative to baseline in the control group (P < .001; 13 patients) but not in the treatment group. ICP decreased significantly relative to baseline over the first 24 hours in the treatment group (P ‫؍‬ .003; 13 patients) but not in the control group. The incidence of IH, defined as a sustained increase in ICP to a level of 25 mm Hg or greater, was significantly higher in the control group (P ‫؍‬ .04). In conclusion, induction and maintenance of hypernatremia can reduce the incidence and severity of IH in patients presenting with ALF. (HEPATOLOGY 2004;39:464 -470.)

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Central Pontine Myelinolysis and the Rate of Correction of Hyponatremia

Gledhill¹,

Thompson²

1989

Archives of Neurology

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Treatment of hyponatraemic seizures with intravenous 29.2% saline.

Cited by 95 publications

References 14 publications

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Clinical practice guideline on diagnosis and treatment of hyponatraemia

The effect of hypertonic sodium chloride on intracranial pressure in patients with acute liver failure

Central Pontine Myelinolysis and the Rate of Correction of Hyponatremia

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