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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Saturday, April 10, 2021

Hypertonic saline for Hyponatremia

SGEM#326 - By admin - Apr 10, 2021
Reference: Risk of Overcorrection in Rapid Intermittent Bolus vs Slow Continuous Infusion Therapies of Hypertonic Saline for Patients With Symptomatic Hyponatremia: The SALSA Randomized Clinical Trial. JAMA Intern Med 2021
“CLINICAL QUESTION: WHEN TREATING SYMPTOMATIC HYPONATREMIA WHAT ARE THE RISKS OF OVERCORRECTION IN PATIENTS USING EITHER A SLOW CONTINUOUS INFUSION VS. A RAPID INTERMITTENT BOLUS OF HYPERTONIC SALINE STRATEGY?
Authors’ Conclusions: “This randomized clinical trial found that both RIB and SIC therapies of hypertonic saline for treating hyponatremia were effective and safe, with no difference in the overcorrection risk. However, RIB had a lower incidence of therapeutic relowering treatment and tended to have a better efficacy in achieving sNa within 1 hour than SCI. RIB could be suggested as the preferred treatment of symptomatic hyponatremia, which is consistent with the current consensus guidelines.” 
KEY RESULT: NO STATISTICAL DIFFERENCE IN OVERCORRECTION BETWEEN THE RAPID INTERMITTENT BOLUS GROUP AND SLOW CONTINUOUS INFUSION GROUP.
SGEM BOTTOM LINE: BOTH RAPID INTERMITTENT BOLUSES OF HYPERTONIC SALINE AND SLOW CONTINUOUS INFUSIONS APPEAR EFFICACIOUS STRATEGIES WITH NO STATISTICAL DIFFERENCE IN SAFETY.”