In Reply: Dr Moritz raises concerns about the safety of infusing 3% sodium chloride (12 mL/kg) over a 4-hour period in the management of seizure associated with severe hyponatremia. This was a phase 4 study to determine if routine use of a new formulation of reduced osmolarity oral rehydration solution (compared with a previous formulation) would be associated with symptomatic hyponatremia; unlike physiological studies, it did not have the provision for frequent monitoring of serum electrolytes.
Alam NH. Fluid Replacement for Severe Hyponatremia—Reply. JAMA. 2007;297(1):41-42. doi:10.1001/jama.297.1.41-b