CHFT Case of the Week 8 – Hyponatraemia
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This weeks case features a critically unwell patient with a very low sodium. Focus is on the hyponatraemia aspect – when and how we should correct low sodiums. This was a particularly tricky case as being critically unwell he would be needing lots of other IV infusions rather than just hypertonic saline as the hyponatraemia guidelines suggest, therefore making careful correction even more difficult.
Links:
Hyponatraemia overview article – https://onlinelibrary.wiley.com/doi/full/10.1111/eci.12465
Flow chart from above article – https://onlinelibrary.wiley.com/cms/asset/7febf78d-09bb-4659-8755-dad999e4e35a/eci12465-fig-0001-m.jpg
Society for Endocrinology guidance – https://www.endocrinology.org/media/xhrhxhxm/emergency-management-of-severe-and-moderately-severely-symptomatic-hyponatraemia-in-adult-patients-2022.pdf
EMBeds hyponatraemia guidance – https://www.embeds.co.uk/2020/01/13/hyponatraemia/
Central pontine myelinolysis – https://en.wikipedia.org/wiki/Central_pontine_myelinolysis
Locked in syndrome – https://en.wikipedia.org/wiki/Locked-in_syndrome