Hyponatremia in Traumatic Brain Injury: A Practical Management Protocol

Background Hyponatremia (defined as serum sodium Methods A retrospective analysis of 1500 consecutively admitted patients with TBI was performed by the use of electronic records and radiographic review. Hyponatremia was defined as serum sodium 40 mEq/L. The incidence of TBI, its management, and the effect of fludrocortisone were evaluated. Results The incidence of hyponatremia was 13.2%. Early therapy with fludrocortisone significantly reduced the duration of hospital stay ( P Conclusion Early initiation of fludrocortisone in the setting of hyponatremia with natriuresis decreases the hospital stay. This protocol is probably safer in a tropical country where fluid restriction might be harmful. It also eliminates the need to differentiate between SIADH and CSW.