Do you routinely use 3% sodium chloride and desmopressin to correct hypovolemic hyponatremia in an asymptomatic patient with serum sodium of less than 120 mEq/L?  

The challenge with hypovolemic hyponatremia lies in the fact that, upon correcting volume depletion, the kidney's capacity to excrete dilute urine returns, potentially leading to a rapid excretion of large volumes of dilute urine. In the case of an asymptomatic patient with a sodium level of 120 mEq...

I agree with Dr. @Al-Awqati. It's very difficult to predict the free water diuresis that will occur following the correction of the volume deficit. I prefer to give an initial isotonic bolus with close monitoring every 3-4 hours of serum Na concentration and urine output. Further management is dicta...

In hypovolemic hyponatremia, the defect in urinary electrolyte-free water excretion is reversible. Correction of hypovolemia with isotonic saline may result in overly rapid correction of hypovolemic hyponatremia once the stimulus for ADH secretion is removed, resulting in the excretion of a very dil...