17. Hyponatremia in Critical Illness with Dr Joel Topf

In this episode of Critical Care Time, Dr. Cyrus Askin and Dr. Nick Mark are joined by Dr. Joel Topf (aka @KidneyBoy) to discuss hyponatremia, a common and potentially serious problem in critically ill patients. They discuss the definition, common etiologies, and complexities of hyponatremia, emphasizing the importance of considering tonicity versus osmolality. The panel explores the challenges of diagnosis and management, including the controversy around correction rates and the risk of osmotic demyelination syndrome (ODS). Dr. Topf introduces the DDAVP clamp as a proactive strategy to prevent overcorrection in high-risk patients, and the group also touches on the interplay between potassium and sodium levels, as well as special considerations for acute versus chronic hyponatremia.