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Why treat with hypertonic saline? Isn't normal saline more hypertonic than the TBW of someone with SIADH? So wouldn't normal saline work to increase serum Na+ and also carry a lower risk of CPM?
You treat SIADH with hypertonic saline only in patients with symptoms.
Otherwise, you do treat them with N saline.
Think of it this way-You want to give as little water to someone who is already overloaded with water.
Remember, SIADH patients retain H2O but they do not have problem excreting Na.
P.S. FA is a great book for review but not for learning.
Yes. That was discussed here.SIADH actually causes a euvolemic hyponatremia.
You are absolutely right.I was taught you don't give NS because the patient will excrete the sodium but keep the water since they are concentrating their urine, therefore NS can act to exacerbate the condition. Just for example, the salt you give them in 1 L they can urinate out in .5 L, leaving them a gain of .5 L free water.