Treatment of adults with moderate to severe hyponatremia (serum sodium <130 mEq/L)

IV: intravenous; SIADH: syndrome of inappropriate antidiuretic hormone secretion.

* Severe symptoms of hyponatremia include seizures, obtundation, coma, and respiratory arrest.

¶ Autocorrection of hyponatremia is present if the serum sodium is rising spontaneously without intervention or treatment. Autocorrection should be suspected, even before a spontaneous rise in serum sodium is noted, in the following hyponatremic patients: those with a rapidly reversible cause of hyponatremia who have a brisk urine output and those with a urine output that is increasing over time and a urine cation concentration (ie, the sum of the urine sodium and potassium concentration) that is lower than the serum sodium.