Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor
To the Editor: The article by Drs Ayus and
Arieff1 adds another 34 patients to the
authors' extensive experience with permanent or fatal brain damage from hyponatremia.
In the past 15 years, Ayus and Arieff have reported more than 200 such patients
referred to them after a respiratory arrest or hypoxic event; the authors
apparently played no role in the management of these cases.1,2
During the same period, the authors directed the treatment of 49 patients
with symptomatic hyponatremia1,3;
no patient developed a respiratory arrest or hypoxic event and all recovered
without sequelae. Apparently, to be treated for hyponatremia by the authors
guarantees protection from hypoxia before treatment and brain damage after
it; to be treated by anyone else risks almost certain respiratory arrest,
death, or disability.
Sterns RH. Treatment of Hyponatremic Encephalopathy. JAMA. 1999;282(24):2298–2299. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-24-jbk1222
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