Investigation and management of severe hyponatraemia in a hospital setting

Aims: To evaluate the assessment and management of severe hyponatraemia in a large teaching hospital. Methods: Inpatients with serum sodium Results: 104 patients with a serum sodium v 27%, p v 11% p v 32%, p = 0.001). Treatment was often illogical with significant management errors in 33%. These included fluid restriction and intravenous saline given together (4%) and fluid restriction in diuretic induced hyponatraemia (6%). Mortality was higher in the group with management errors (41% v 20% p = 0.002). Conclusion: Severe hyponatraemia is a serious condition, but its investigation and evaluation is often inadequate. Some treatment patterns seem to be arbitrary and illogical, and are associated with higher mortality.