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Sodium decrease
My father's sodium value was 117 in the morning. He got admitted and sodium was given to him. After 12 hours, now his sodium is 114 . Is it possible that value decreases after giving sodium through IV?
✓Most likely SIADH (Syndrome of Inappropriate ADH secretion) ..
usually it's Seen with infections, stroke, medications, pain, nausea ..
Next Steps
✓some tests like Serum osmolality,
Urine sodium & urine osmolality,
Thyroid function (TSH) and
Serum cortisol needs to be done .
Health Tips
✓Sodium can fall even after IV treatment if the body is retaining excess water.
✓The problem is not lack of sodium, but imbalance of water hormones.
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While we are giving sodium correction, we’ll have to look for the cause of decreased sodium and eliminate it. Also don’t worry rapid correction is usually avoided, hence for a sodium level of 117 it will take 2-3 days to get it to the normal levels. You can opt for online consultation for detailed assessment and other queries.
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This is a serious blood result and please be guided by doctors treating your father and would advise against making your own assessments.
(We use the following phrases to help manage cases like this with low sodium:
*Symptomatic
*Acute vs recurrent vs chronic
*Volume status
*Trigger/s
*Sodium loading
*Slow correction ie 8-10mmol/L to avoid Osmotic demyelination)
All the best.
J G S R clinic
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It is a case of symptomatic hyponatremia.
Can you provide patient’s any drug intake history and other medical history. Because it can be due to multiple causes.
Next Steps
Advise- RFT, ABG, serum osmolarity, urine osmolarity, urine spot sodium, urine routine, fasting lipid profile, TFT, serum random cortisol for further evaluation.
Health Tips
It is medical emergency, we have to improve serum sodium very cautiously according to guidelines.
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Yes, it is possible for sodium to decrease even after giving sodium through IV, and this situation is not uncommon, especially in severe hyponatremia.
Next Steps
Do not panic, but do not ignore it either.
This situation requires experienced medical supervision, which he is already getting by being admitted.
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Hyponatremia in elderly have multiple causes .drugs like antihypertensive hydrochlorthiazide most common…even after iv Na not correcting meaning . On going Na loss is there ..so look for causes. Admit best set up because wrong admission of Na may cause demyelination syndrome means lower lim paralysis . Na is critically low may cause seizures
Health Tips
Get admit in best critical care set up unit hospital
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