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General Critical Care

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Multicenter study of hospital admissions in greater Toronto: Osmotic Demyelination Syndrome occurrence and rapid correction of serum sodium

This multicenter study which was published in NEJM Evidence this month examined 22,858 hospital admissions in greater Toronto for patients with hyponatremia (low sodium levels). Osmotic Demyelination Syndrome (ODS) occurred in a small proportion of patients (0.14%), even when they underwent rapid correction of serum sodium. The study found that rapid correction of serum sodium did not generally cause ODS, and that other unidentified factors must be involved in ODS development. Certain factors were more frequent in the ODS group, including initial serum sodium levels below 110 mmol/l, positive alcohol level, and hypokalemia. The study had several limitations, including possible lack of generalizability, missing data, and the small number of ODS patients, which limited the ability to identify specific risk factors or define safe rates of serum sodium correction. The authors concluded that while rapid serum sodium correction occurred in about 18% of hyponatremic patients, ODS was observed in only 0.05% of them, suggesting a need for further studies to understand potential causal factors for ODS.

Osmotic Demyelination Syndrome in Patients Hospitalized with Hyponatremia | NEJM Evidence

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