Is the risk of ODS the same at all levels of starting PNa levels? And if not, perhaps we do not need to re-lower the PNa if starting in the mid-120s?
The discussion focused on several points:
The relative change in serum osmolality (and therefore shifting of brain water) is not the same with a 12 meq/L PNa change when you consider, for example, starting at a PNa of 110 vs. 125. Thus, you would not expect the risk of ODS to be the same in those two patients. This is confirmed by the fact that