<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_ajon-2017-002_s_001" sec-type="background"><h3>Background statement</h3><p>Developing hyponatraemia after a subarachnoid haemorrhage is common, however it is known to worsen patient outcomes. This paper aims to review the practice of managing hyponatraemia in acute subarachnoid haemorrhage patients with administration of 3% hypertonic saline solution.</p></sec><sec id="j_ajon-2017-002_s_002" sec-type="aim"><h3>Aim</h3><p>To enquire into the practice and policy of one of Melbourne’s large Metropolitan hospital’s current management of hyponatraemia in subarachnoid haemorrhage patients, and determine if the policy is both current and evidenced based.</p></sec><sec id="j_ajon-2017-002_s_003" sec-type="methods"><h3>Methods</h3><p>A search of the terms “subarachnoid haemorrhage”, “hyponatraemia” and “hypertonic saline” was used in databases including Pubmed, Medline and CINAHL. Literature was included if it discussed the use of hypertonic saline for hyponatraemia, the effect of hyponatraemia on subarachnoid haemorrhage patients and the potential causes of acute hyponatraemia. The articles and literature reviews were assessed for inclusion by the author.</p></sec><sec id="j_ajon-2017-002_s_004" sec-type="results"><h3>Results</h3><p>Patients with a subarachnoid haemorrhage and hyponatraemia should not be fluid restricted, as this is contraindicated. Patients should be administered 3% hypertonic saline to avoid hypovolaemia and slowly increase serum sodium to prevent onset or exacerbation of cerebral oedema.</p></sec><sec id="j_ajon-2017-002_s_005" sec-type="limitation"><h3>Limitation</h3><p>Lack of evidence based data and studies in regard to the dosing of hypertonic saline resulted in the lack of consensus with prescribing rates and volumes to be infused for severe hyponatraemia.</p></sec></abstract>

Background statementDeveloping hyponatraemia after a subarachnoid haemorrhage is common, however it is known to worsen patient outcomes. This paper aims to review the practice of managing hyponatraemia in acute subarachnoid haemorrhage patients with administration of 3% hypertonic saline solution.AimTo enquire into the practice and policy of one of Melbourne’s large Metropolitan hospital’s current management of hyponatraemia in subarachnoid haemorrhage patients, and determine if the policy is both current and evidenced based.MethodsA search of the terms “subarachnoid haemorrhage”, “hyponatraemia” and “hypertonic saline” was used in databases including Pubmed, Medline and CINAHL. Literature was included if it discussed the use of hypertonic saline for hyponatraemia, the effect of hyponatraemia on subarachnoid haemorrhage patients and the potential causes of acute hyponatraemia. The articles and literature reviews were assessed for inclusion by the author.ResultsPatients with a subarachnoid haemorrhage and hyponatraemia should not be fluid restricted, as this is contraindicated. Patients should be administered 3% hypertonic saline to avoid hypovolaemia and slowly increase serum sodium to prevent onset or exacerbation of cerebral oedema.LimitationLack of evidence based data and studies in regard to the dosing of hypertonic saline resulted in the lack of consensus with prescribing rates and volumes to be infused for severe hyponatraemia.

Treatment of subarachnoid haemorrhage complicated by hyponatraemia

Australasian Journal of Neuroscience

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Treatment of subarachnoid haemorrhage complicated by hyponatraemia"}

Background statementDeveloping hyponatraemia after a subarachnoid haemorrhage is common, however it is known to worsen patient outcomes. This paper aims to...

Hyponatraemia	Serum sodium range	Symptoms
Mild hyponatraemia	130-135 mmol/L	Nausea, vomiting, short-term memory loss & dizziness.
Moderate hyponatraemia	121-129 mmol/L	Confusion, muscle weakness, generalised malaise & headaches.
Severe hyponatraemia	<120 mmol/L	Lethargy, agitation, increased ICP, respiratory depression, cerebral oedema & disorientation.

Treatment of subarachnoid haemorrhage complicated by hyponatraemia

Article Category: case-report

Published Online: Nov 30, 2017

Page range: 1 - 5

DOI: https://doi.org/10.21307/ajon-2017-002

Keywords
Subarachnoid haemorrhage, hyponatraemia, hypertonic saline

© 2017 Jordyn A Butler., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Serum sodium levelsThis table lists serum sodium ranges of hyponatraemia and associated symptoms (Stern, 2015).

Treatment of subarachnoid haemorrhage complicated by hyponatraemia

Article Category: case-report

Published Online: Nov 30, 2017

Page range: 1 - 5

DOI: https://doi.org/10.21307/ajon-2017-002

KeywordsSubarachnoid haemorrhage, hyponatraemia, hypertonic saline

© 2017 Jordyn A Butler., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Serum sodium levelsThis table lists serum sodium ranges of hyponatraemia and associated symptoms (Stern, 2015).

Keywords
Subarachnoid haemorrhage, hyponatraemia, hypertonic saline