CHSU Discovery

Abstract

• Severe hyponatremia (serum sodium level ≤ 120 mmol/L) management guidelines recommend administering hypertonic sodium chloride (HTS) to initially raise serum sodium levels by 4-6 mmol/L.
• While various HTS doses and concentrations are used, an initial dose of 100 mL 3% HTS is frequently cited. Despite its widespread adoption, this approach is associated with administration delays and medication preparation errors.
• A 50 mL solution of 8.4% sodium bicarbonate (HTB) provides the same sodium content as a 100 mL 3% HTS solution. Furthermore, HTB is commercially available as a 50 mL prefilled syringe, circumventing the potential for medication administration errors and delays.
• HTB is recognized as a treatment option for managing cerebral edema in neurocritical care guidelines, but is not recognized as a treatment option in hyponatremia management guidelines.
• Study Purpose: determine if 8.4% HTB is an effective alternative to 3% HTS in the management of severe hyponatremia