Metabolic Brain Disease

, Volume 25, Issue 1, pp 91–96 | Cite as

100 cc 3% sodium chloride bolus: a novel treatment for hyponatremic encephalopathy

  • Michael L. Moritz
  • Juan Carlos Ayus
Original Paper


Hyponatremic encephalopathy is a potentially lethal condition with numerous reports of death or permanent neurological injury. The optimal treatment for hyponatremic encephalopathy remains controversial. We have introduced a unified approach to the treatment of hyponatremic encephalopathy which uses 3% NaCl (513 mEq/L) bolus therapy. Any patient with suspected hyponatremic encephalopathy should receive a 2 cc/kg bolus of 3% NaCl with a maximum of 100 cc, which could be repeated 1–2 times if symptoms persist. The approach results in a controlled and immediate rise in serum sodium with little risk of inadvertent overcorrection.


Hyponatremia Encephalopathy Fluid therapy Myelinolysis Arginine vasopressin 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Nephrology, Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMCThe University of Pittsburgh School of MedicinePittsburghUSA
  2. 2.Renal Consultants of HoustonHoustonUSA

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