Diagnosis and emergency treatment of hyponatremia

The article was professionally consulted by Specialist Doctor I Do Van Manh - Emergency Department - Vinmec Ha Long International Hospital.

Hyponatremia occurs when the sodium level in the blood is below the normal range. Sodium is an electrolyte that helps regulate the amount of water in and out of cells. When hyponatremia causes the amount of sodium in the body to be diluted and water in the body increases, causing the cells to begin to swell. This condition can have a variety of consequences, even being life-threatening.

Sodium plays a very important role in the body. Sodium helps maintain normal blood pressure, supports nerve and muscle function, and regulates fluid balance in the body. What is hyponatremia? Normal blood sodium levels are between 135 and 145 mEq/L. Hyponatremia occurs when the sodium in the blood falls below 135 mEq/L.
There are many medical conditions and lifestyle factors that can lead to hyponatremia, including:
Certain medications, such as diuretics, antidepressants, and pain relievers, can interfere with hyponatremia. hormone production and normal blood filtration by the kidneys to keep sodium levels within the normal range. Heart, kidney and liver problems. Congestive heart failure and certain diseases that affect the kidneys or liver can cause fluid to build up in the body, diluting the blood sodium. Syndrome of inappropriate antidiuretic hormone (ADH) secretion (SIADH). In this syndrome, more than normal levels of anti-diuretic hormone (ADH) are produced, causing the body to retain water instead of having to excrete it in the urine.

Chronic vomiting, severe vomiting or diarrhea and other causes of dehydration. These factors all cause the body to lose electrolytes and also increase ADH levels. Drink too much water. Drinking too much water can cause low sodium by increasing the kidneys' ability to excrete water. In addition, the body can lose sodium through sweat, drinking too much water during physical activities, such as marathons and triathlons, can also dilute the sodium content in the blood. Hormonal changes. Adrenal insufficiency (Addison's disease) affects the adrenal glands' ability to produce hormones that help maintain sodium, potassium, and water balance in the body. Low thyroid hormone levels can also cause low blood sodium levels. Amphetamine or ecstasy increases the risk of severe and even fatal hyponatremia.

In chronic hyponatremia, sodium levels gradually decrease over 48 hours or so, and symptoms and complications are usually moderate.
In acute hyponatremia, sodium levels drop rapidly leading to dangerous effects, such as cerebral edema which can lead to coma and death.
Premenopausal women have the highest risk of brain damage from hyponatremia. This may be due to the effect of hormones on the body's ability to balance sodium levels.

Signs and symptoms of hyponatremia include:
Nausea and vomiting Headache Confusion Fatigue, drowsiness Restlessness and irritability Muscle weakness, spasms or cramps Convulsions Coma Need to get the person to the muscle Get medical help right away if you have severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or loss of consciousness.

At a medical facility, the doctor will diagnose hyponatremia by asking about the patient's medical history and doing a general physical examination.
However, because the signs and symptoms of hyponatremia occur in a wide variety of conditions and these conditions cannot be diagnosed solely on the basis of symptoms of hyponatremia, a more in-depth examination is required. again. To confirm low blood sodium, your doctor will order blood tests and urine tests.

Emergency treatment of hyponatremia aims to address the underlying cause. If you have moderate hyponatremia, due to diet, diuretics, or excessive fluid intake, your doctor may recommend temporarily reducing fluid use and adjusting the amount of diuretic you are taking. to increase the level of sodium in the blood.
If the patient has severe and acute hyponatremia, the patient needs to treat hyponatremia more aggressively by:
Intravenous fluid infusion: The doctor may prescribe intravenous sodium infusion. blood vessels to slowly increase the concentration of sodium in the blood. Medication: Medications can be used to control the signs and symptoms of hyponatremia, such as headaches, nausea, and seizures.

The following measures can help prevent hyponatremia:
Treat existing medical conditions. Treating conditions that can potentially cause hyponatremia, such as adrenal insufficiency, can help prevent future hyponatremia. Be aware of the signs and symptoms of hyponatremia when you have a medical condition or use medications that increase your risk of hyponatremia. Consider using sports drinks that contain electrolytes when doing endurance sports like marathons, triathlons, and other physical activities. Drink water in moderation. Drinking water is very important for your health, so you should drink enough fluids but don't overdo it. Feeling thirsty and the color of your urine (dark urine) are often the best indications of how much water you need. If you don't feel thirsty and your urine is light yellow, you're likely getting enough water. Hyponatremia causes many serious complications, even coma, death if not treated promptly. To prevent this disease, you should follow the above measures and see a doctor as soon as the body has the first signs.

Specialist Doctor Do Van Manh has more than 10 years of experience in the field of Critical Care - Anti-poison. He used to be the Deputy Head of the Intensive Care Unit at Quang Ninh General Hospital before working at Vinmec Ha Long International Hospital.
To register for examination and treatment at Vinmec International General Hospital, you can contact the nationwide Vinmec Health System hotline, or register online HERE.
References: mayoclinic.org
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