Endocrine Abstracts

Hyponatraemia is the commonest electrolyte disturbance in hospitalised patients. Acute severe hyponatraemia is a medical emergency, leading to potential cerebral oedema and death if not actively managed. Prompt intervention with hypertonic saline is recommended to reverse neurological symptoms and prevent brain herniation, aiming for an initial sodium increase of 4 to 6 mmol. Overcorrection runs the risk of osmotic demyelination syndrome, hence further rapid sodium rise (to a limit of no more than 10 to 12 mmol within 24 hours) should be avoided. Lowering of sodium levels using intravenous 5% dextrose with or without desmopressin may be required under such circumstances. This presentation will review the principles of management of severe hyponatraemia, including recent evidence highlighting the importance of active management, and the benefits of bolus versus slow infusion of hypertonic saline.