To our knowledge, this is the first study to compare the effect of 3% saline (HS) and conivaptan intervention for the management of hyponatremia. Subjects and Methods In this single-center retrospective study, we compared the efficacy of HS and conivaptan in achieving hyponatremia treatment goals according to expert guidelines.4 Inclusion criteria consisted of patients hospitalized at TMH in Houston, Texas, with computerized provider Inhibitors,research,lifescience,medical order entries (CPOE) for intravenous HS or conivaptan.

Upon approval by TMH Institutional Review Board, the research team retrieved CPOE for HS and conivaptan from January 2009 through November 2010 (Figure 1). Of the total 731 CPOE identified, 310 were unique to single patients during a single hospitalization; of these, 117 were followed by administration of HS or conivaptan. Review of records from the excluded 193 patients revealed that administration of either HS or conivaptan was held after a pretreatment measurement of [Na+] showed an increase toward normal value (Figure Inhibitors,research,lifescience,medical 1). Figure 1. Flow diagram of patient identification, exclusion, and analysis.C: conivaptan; Inhibitors,research,lifescience,medical DDAVP: 1-deamino-8-D-arginine vasopressin; HS: 3% saline. Data including demographics, clinical presentation

(e.g., postoperative state), clinically Tyrosine Kinase Inhibitor Library estimated volume status, medications known to cause hyponatremia, comorbid conditions, and suspected presence of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) on clinical grounds as a cause of the patient’s hyponatremia were collected by chart review. Also retrieved were [Na+] at baseline and, when available, within 4, 12, 24, and 48 hours (± 1 hour) after the initiation of HS or conivaptan. All 49 patients analyzed had Inhibitors,research,lifescience,medical follow-up measurements of [Na+] within the expected 4, 12, 24, and 48 hour time frames. Over-correction was based on hyponatremia treatment guidelines4 and defined as exceeding

the change in [Na+] of 4 mEq/L at 4 hours, 12 mEq/L at 24 hours, or 18 mEq/L at 48 hours after initiation of therapy. Data analysis was performed using Intercooled Stata Inhibitors,research,lifescience,medical version 9.2 (Stata Corporation, College Station, Texas). Statistical significance was defined PD184352 (CI-1040) as P <0.05. Categorical data, summarized as percentages, were compared with the chi-square test. For quantitative data, 2-tailed Student’s t-test was performed. In cases of non-normally distributed data, Wilcoxon rank-sum analysis was performed. Results are presented as mean ± standard deviation. Results Patient demographics are summarized in Table 1. The mean age for the HS group was 69.3 years and 77.7 years for the conivaptan group. Caucasians comprised the majority of the study’s population in both groups. In the HS group, 76% of patients were euvolemic, as were 66% in the conivaptan group. The remaining patients in each group were hypervolemic; no hypovolemic patients were identified.