title: Management of hyponatremia and volume contraction.
abstract: Hyponatremia is the most common electrolyte imbalance seen in patients with aneurysmal subarachnoid hemorrhage, occurring in one-third to one-half of patients. Hyponatremia may be caused by cerebral salt wasting and by the syndrome of inappropriate secretion of antidiuretic hormone or a combination of both. Limited data are available describing hyponatremia treatment in subarachnoid hemorrhage patients. A Medline search was performed for English-language manuscripts describing original research in the treatment for hyponatremia in patients with aneurysmal subarachnoid hemorrhage. Seven appropriate articles were identified as followed: three testing fludrocortisone, two hydrocortisone, and one each for hypertonic saline and 5% albumin. Data quality for treatment efficacy and safety were moderate for corticosteroid studies and low or very low for hypertonic saline and 5% albumin. Available data, although limited, support early treatment with corticosteroids to limit hyponatremia, with fludrocortisone causing fewer side effects.
authors: Department of Neurology, Mayo Clinic, 200 First Street, SW-Mayo W8B, Rochester, MN 55905, USA. Rabinstein.alejandro@mayo.edu
authors: Alejandro A
authors: AA
authors: Rabinstein
authors: Nicolas
authors: N
authors: Bruder
mesh_terms: D000208:Acute Disease; D003422:Critical Care / Q000379:methods; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000628:therapy*; D020896:Hypovolemia / Q000209:etiology / Q000628:therapy; D012965:Sodium Chloride / Q000627:therapeutic use*; D013345:Subarachnoid Hemorrhage / Q000150:complications*
chemical_list: D012965:Sodium Chloride