Treatment of SIADH: See Diff Dx
- Correction of Underlying Dz if present;
- Rapid correction during acute treatment should not exceed 20 mEq/lit rise in serum Na concentration during 1st 48 hrs of Rx; (otherwise may develop Central Pontine Myelinosis);
- goal is to correct Serum Sodium to a minimum of 125 mEq/lit.
- Water restriction, usually to less than insensible losses (less than 500 to 1000 ml/day)
- once the Serum Na rises to 120-125 the symptoms will begin to lessen;
- Severe Hypo Na:
- in addition to first two measures, pts w/ severe symptomatic hypoNa (serum Na of < 115 mmol/L) may benefit from Lasix w/ hourly replacement of urinary sodium and potassium losses using NS;
- very rarely 3% saline will be required;
- 300 to 600mg PO bid is occassionally useful in pts w/ chronic symptoms of SIADH in whom water restriction has been unsuccessful
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Wednesday, September 5, 2012 7:54 pm