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Hyponatremia is a common condition in clinical practice characterized by low blood sodium levels (<135 mmol/L), which can have severe neurological consequences and increase the risk of mortality. It’s management requires identifying the underlying cause, which can sometimes be challenging.
We propose the use of point-of-care ultrasound (PoCUS) as a valuable tool for phenotyping hyponatremia based on extracellular volume and determining the potential etiology. We present five clinical cases from a third-level hospital in Colombia, describing the findings associated with each case.
Presentation of five clinical cases of patients treated at a third-level hospital in Colombia between January and June 2023, who presented with hyponatremia of various etiologies. In these cases, PoCUS was performed, and the documented findings were correlated with the flowchart presented in Figure 1, leading to a change in medical management.
We describe five cases of patients in surgical and critical care hospitalization settings with hyponatremia secondary to the following etiologies: adrenal insufficiency, heart failure, cerebral salt-wasting syndrome, and hypoalbuminemia, in which the inclusion of PoCUS altered the management approach (Table 1).
Hyponatremia demands a comprehensive evaluation. Non-invasive methods are proposed, such as PoCUS, which, in conjunction with clinical findings and paraclinical tests, enable the characterization of patients volume status and determination of the type of hyponatremia. Estimating extracellular volume offers clues regarding the etiology. Despite its usage limitations and the scarce literature in this domain, its implementation emerges as an innovative strategy to enhance early identification and management of hyponatremia.