Burst Volker, Hensen Johannes
Klinik II für Innere Medizin: Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Universitätsklinik Köln.
Medizinische Klinik, Klinikum Region Hannover (KRH), Klinikum Nordstadt, Hannover.
Dtsch Med Wochenschr. 2015 Apr;140(8):608-11. doi: 10.1055/s-0041-101194. Epub 2015 Apr 16.
Guidelines have become very common in modern medicine. Their primary aim should be to provide evidence-based guidance and insight and to help to convey the best possible care to patients. As a consequence, guidelines also play a critical role in liability issues. Hyponatremia is a frequently encountered condition which is considered challenging by many physicians. It is therefore highly appreciated, that two interdisciplinary guidelines on hyponatremia have been published recently. Unfortunately, the given recommendations differ substantially. Most importantly, the roles of existing new and old treatment options are rated inconsistently. This demonstrates once again that guidelines never tell the whole truth and that we are well advised not to trust them blindly. Given the lack of valid evidence from controlled trials, the current guidelines can only offer another overview on hyponatremia but they certainly fail to provide clear-cut recommendations. The content and controversies of both publications are described in this commentary.
指南在现代医学中已非常普遍。其主要目的应是提供循证指导与见解，并有助于为患者提供尽可能最佳的护理。因此，指南在责任问题中也起着关键作用。低钠血症是一种常见病症，许多医生认为它具有挑战性。因此，最近发表了两份关于低钠血症的跨学科指南，这一点值得高度赞赏。不幸的是，给出的建议差异很大。最重要的是，现有新旧治疗方案的作用评估不一致。这再次表明，指南永远不会说出全部真相，我们最好不要盲目信任它们。鉴于缺乏来自对照试验的有效证据，当前的指南只能提供关于低钠血症的另一种概述，但它们肯定无法提供明确的建议。本评论描述了这两份出版物的内容及争议。
