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100 cc 3% sodium chloride bolus: a novel treatment for hyponatremic encephalopathy

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Abstract

Hyponatremic encephalopathy is a potentially lethal condition with numerous reports of death or permanent neurological injury. The optimal treatment for hyponatremic encephalopathy remains controversial. We have introduced a unified approach to the treatment of hyponatremic encephalopathy which uses 3% NaCl (513 mEq/L) bolus therapy. Any patient with suspected hyponatremic encephalopathy should receive a 2 cc/kg bolus of 3% NaCl with a maximum of 100 cc, which could be repeated 1–2 times if symptoms persist. The approach results in a controlled and immediate rise in serum sodium with little risk of inadvertent overcorrection.

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Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMC, The University of Pittsburgh School of Medicine, One Children’s Hospital Drive, 4401 Penn Ave, Pittsburgh, PA, 15224, USA

    Michael L. Moritz

  2. Renal Consultants of Houston, Houston, TX, USA

    Juan Carlos Ayus

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  1. Michael L. Moritz
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  2. Juan Carlos Ayus
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Correspondence to Michael L. Moritz.

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Moritz, M.L., Ayus, J.C. 100 cc 3% sodium chloride bolus: a novel treatment for hyponatremic encephalopathy. Metab Brain Dis 25, 91–96 (2010). https://doi.org/10.1007/s11011-010-9173-2

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  • DOI: https://doi.org/10.1007/s11011-010-9173-2

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