How should hyponatremia be treated to avoid neurological complications?

In the management of hyponatremia, it is critical to correct sodium levels slowly to mitigate the risk of neurological complications. Rapid correction of low sodium levels can lead to osmotic demyelination syndrome, a serious condition that results from the rapid influx of sodium into the central nervous system, leading to brain cell shrinkage and subsequent injury.

When sodium levels fall, the body adapts over time by adjusting osmotic balances, particularly through the movement of fluid into and out of brain cells. A sudden increase in sodium levels disrupts this balance quickly, resulting in water moving out of the cells at a rate that can be harmful. Therefore, the recommended approach is to raise sodium levels no more than 6-8 mEq/L in a 24-hour period, allowing the body to adjust and minimizing the risk of complications.

This cautious approach not only ensures safer outcomes but also preserves neurological function and avoids long-term deficits that can arise from overly aggressive treatment.