[Prognosis and treatment of symptomatic hyponatremia--a study of 28 intensive care cases].

In symptomatic cases of hyponatraemia, where the serum sodium concentration is less than 115 mmol/l, prognosis has hitherto been considered to be poor, and mortality rates of 50 per cent have been reported. The management of this condition is controversial, particularly concerning the optimal rate of correction, correlations having been reported between the occurrence of central pontine myelinolysis and both over-correction and too rapid correction. During the 3-year duration of the study reported in the article, of 28 cases with a mean sodium concentration of 106 mmol/l, the outcome was fatal in only one case. In both of the only two cases of acute hyponatraemia (i.e., developing within 24 hours), correction had been rapid (mean rate 2.6 mmol/l per hour). In the remaining 26 cases correction of chronic hyponatraemia was slower (mean rate 0.6 mmol/l per hour), adjustment to a slightly hyponatraemic level having been achieved with isotonic saline (N = 25) or water restriction (N = 1). The findings in the study suggest that, provided that the rate of correction is not too rapid, the prognosis in cases of severe symptomatic hyponatraemia is more favourable than previously reported.