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Many patients not treated for easily corrected life-threatening condition, new study shows

A ten-year-old error in the medical literature continues to cause doctors to improperly treat a potentially life-threatening condition affecting tens of thousands of hospital patients a year, a new study has shown.

The malady, called hyponatremic encephalopathy, involves brain swelling and other symptoms, killing a fourth of all patients who develop it if not treated properly. Its cause is low salt concentrations in the blood, a condition which can be quickly and easily remedied, leading almost always to a full recovery if treated properly, a medical team reports.

This conclusion, based on a study of the treatment received by 53 hospitalized postmenopausal women with the condition, is published in the June 23 issue of the Journal of the American Medical Association (JAMA). The authors are J. Carlos Ayus, MD, professor of medicine at Baylor College of Medicine, and Allen I. Arieff, professor of medicine at the University of California, San Francisco (UCSF).

Their hospital-based study, backed up by a review of all available reports in the medical literature, estimates that the condition is incorrectly treated almost half of the time.

The correct treatment, they report, is the simple procedure of increasing patients' salt concentration intravenously within recommended guidelines, usually only for about two days. But about half of medical professionals nationwide mistakenly believe that such a sodium chloride IV infusion may cause brain damage, they report.

Instead, Ayus and Arieff say, it is withholding salt IV that actually causes the patients to suffer brain seizures. If untreated, this can be followed by respiratory failure and death.

"This belief that the salt IV will lead to brain damage has been in the literature for more than a decade," said UCSF's Arieff. "Our study shows that it is mistaken. Every patient treated with the IV as the paper describes fully recovered, and was fine a year later."

By contra
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Contact: Wallace Ravven
wravven@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
23-Jun-1999


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