Retrospective evaluation of 3% NaCl treatment in patients with symptomatic hyponatremia in the emergency department

Aim: As the most common electrolyte disorder in the Emergency Department, hyponatremia is a serious medical condition associated with a high risk of morbidity and mortality. Hypertonic saline is an effective treatment for symptomatic hyponatremia. This study aims to determine the effective variables in serum sodium elevation and overcorrection with 3% NaCl treatment in patients with symptomatic hyponatremia in the emergency department.Material and Methods: In this study, we conducted a retrospective analysis of the efficacy of 3% NaCl treatment in symptomatic hyponatremic patients over 18 years of age. We described patients' characteristics and outcome variables.Results: In our study, 582 patient files were reviewed. In total, 270 patients were excluded from the study. Ultimately, 312 patients were included in our study. The mean baseline sNa in the patients was 116 +/- 4.5 mmol/L. The most common Hypertonic 3% NaCl treatment was Rapid Intermittent Bolus with a rate of 64.4%. A minimum of 5 mmol/l increase in serum Na was observed in 36.5% of patients following the first treatment. In any period, 20.5% of patients had a rise in sNa of more than 10 mmol/L within the first 24 h.Discussion: For treating symptomatic hyponatremia with 3% NaCl, a target serum Na of 125 mmol/L may be used along with a 5 mmol/L increase in serum Na. In the prevention of excessive serum Na elevation, 3% NaCl treatment in a volume smaller than baseline serum Na levels 125 mmol/L may be considered