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Table 1 Management of suspected hypervolaemic hyponatraemia arising from fluid overload >1000 ml with hypotonic distension media

From: BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy

Acute hypervolaemic hyponatraemiaa

Management

Asymptomatic hyponatraemia & [Na+] ≥120 mmol/L

Fluid restriction (e.g., <1 L/day) and loop diuretics e.g.,40 mg frusemide

Symptomatic hyponatraemia and/or [Na+] <120 mmol/L

Hypertonic (3 %,) saline (1 L = 513 mmol/L NaCl compared with normal saline where 1 L = 154 mmol/L), supplemental oxygen, indwelling urinary catheter, high dependency care and multidisciplinary team involvement

  1. anormal serum sodium levels are approximately between 135 and 145 mmol/L