- 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;
- Demeclocycline: - 300 to 600mg PO bid is occassionally useful in pts w/ chronic symptoms of
SIADH in whom water restriction has been unsuccessful; ---------------------
The syndrome of inappropriate antidiuretic-hormone secretion following spinal fusion.
