title: 100 cc 3% sodium chloride bolus: a novel treatment for hyponatremic encephalopathy.
abstract: Hyponatremic encephalopathy is a potentially lethal condition with numerous reports of death or permanent neurological injury. The optimal treatment for hyponatremic encephalopathy remains controversial. We have introduced a unified approach to the treatment of hyponatremic encephalopathy which uses 3% NaCl (513 mEq/L) bolus therapy. Any patient with suspected hyponatremic encephalopathy should receive a 2 cc/kg bolus of 3% NaCl with a maximum of 100 cc, which could be repeated 1-2 times if symptoms persist. The approach results in a controlled and immediate rise in serum sodium with little risk of inadvertent overcorrection.
authors.affiliation: Division of Nephrology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, The University of Pittsburgh School of Medicine, One Children's Hospital Drive, 4401 Penn Ave, Pittsburgh, PA 15224, USA. moritzml@upmc.edu
authors.forename: Michael L
authors.initials: ML
authors.lastname: Moritz
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Ayus
mesh_terms: D001921:Brain / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D001928:Brain Diseases, Metabolic / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose / Q000517:prevention & control; D006801:Humans; D006955:Hypernatremia / Q000517:prevention & control; D007010:Hyponatremia / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D007049:Iatrogenic Disease / Q000517:prevention & control; D012965:Sodium Chloride / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D012965:Sodium Chloride; D003894:Deamino Arginine Vasopressin