hypona+

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Sherry wrote:

Like to get some opinions...
In many of our trauma patients hyponatremia seems to be a fairly common
issue (127-135) range. The severe <120 is rare... This seems to occur in
both head injured and not. Any guidelines, thoughts? I had heard that
narcotics can be a cause of hypona.

Our current practice is to replete by way of 3%, fluid restriction, and the
addition of salt tabs. I was informed yesterday about a med called florinef
(a mineralocorticoid)
and told it prevents dumping of na in patients. I was also told that brain
naturetic peptide can be measured and repleted if necessary.

hoping to learn more about this topic. any articles / infor appreciated.


Scott P. Sherry, MS, PA-C


Joe replied:

Sherry,

Although I cannot quote you anything off the top of my head wrt hyponatremia and
trauma, there is plenty of literature on the medical side when it comes to low
Na and sick patients (plenty of physiologic reasons)...the levels of low Na you
quote however are NOT clinically significant... be that is it may we need to be
aware of this rather frequent problem so as to not further accentuate the
problem...agree with fluid restriction/use of florinef...measuring BNP is
possible but I am not aware of benefit


nemeth
Emergency Medicine
Mcgill University

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