All right, so welcome back to the Internet Book of Critical Care podcast.

I'm here with Adam Thomas and we're going to talk about hyponatremia.

You'll be hard pressed not to come across a case where you don't need to know hyponitremia cold.

And in today's podcast, we even have an oral champagne that Brussels Spritzer for you, eh?

Exactly.

So come take a listen of risk stratification, identification, and treatment.

We'll throw in that DD AVP clamp just for you guys.

So Josh, start us off.

Let's get into diagnosis.

Hypoenitriya, one of the most common electrolyte abnormalities.

And this really spans the whole gamut from patients who are really dying from hyponatremia

to the vast majority where it's just a ride-along abnormality. And we don't need to do much

about it. And then there are some patients who are at more risk due to our therapies than

the hyponatremia initially. So it's pretty interesting just approaching these different patients. Probably the most important initial thing is determining whether or not patients are symptomatic. And typically we're

thinking about seizures, delirium, nausea and vomiting, headache. And these can be somewhat

unimpressive. And then you even through the rarer but real things out there of neurogenic

palmyidema, which is pretty cool. Yeah, I've never seen that, but supposedly it can happen with like super cute hypotrimia.

Have you ever seen it?

I've seen it in clinical presentations that are confounded.

So there's something called swimmer-induced pulmonary edema, and the patient was hyponatrimic

2 in the setting of an iron man.

So it's hard to say, was it the swimming-induced pulmonary edema or was it something else?

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