{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:14:06Z","timestamp":1763644446000,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,9,22]],"date-time":"2024-09-22T00:00:00Z","timestamp":1726963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hyponatraemia is a prevalent electrolyte disturbance observed in critically ill patients. The rapid correction of low plasma sodium levels by continuous renal replacement therapy (CRRT) carries the risk of developing osmotic demyelination syndrome (ODS), which can be prevented by implementing an individualized CRRT method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aims to introduce a CRRT protocol for the safe and gradual correction of severe hyponatraemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>This retrospective case series study was conducted in an intensive care unit (ICU). All four patients with severe hyponatraemia (&lt;125\u2009mmol\/L) and renal failure between October 1, 2022, and September 30, 2023, were treated by CRRT with sterile water and regional citrate anticoagulation (RCA). Data on patient demographics, laboratory biochemical parameters, urine outputs and CRRT\u2010related adverse events were collected. Laboratory parameters and urine outputs were compared by paired t\u2010tests before and after CRRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After CRRT, sodium levels were significantly increased (112.7\u2009\u00b1\u20096.7 vs. 141.9\u2009\u00b1\u20092.8\u2009mmol\/L, <jats:italic>p<\/jats:italic>\u2009=\u2009.005). Abnormal urine outputs, potassium, creatinine and bicarbonate were corrected (<jats:italic>p<\/jats:italic> for all &lt;.05). Safe and gradual correction of hyponatraemia and internal environmental dysregulation was achieved in all patients without any complications related to CRRT, particularly ODS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is a novel and simple strategy to correct severe hyponatraemia effectively while ensuring the safety of patients that can be easily implemented by experienced nurse staff.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to Clinical Practice<\/jats:title><jats:p>The sterile water\u2010based protocol for postfilter dilution is safe to correct severe hyponatraemia with RCA and can be easily performed by experienced critical care nurses according to the precalculated formula. CRRT\u2010trained, experienced ICU nurses are competent to initiate and adjust sterile water infusion discretely to prevent overcorrection of hyponatraemia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nicc.13167","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T06:48:54Z","timestamp":1727074134000},"page":"1450-1459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sterile water and regional citrate anticoagulation: A simple <scp>CRRT<\/scp> strategy for safe correction of severe hyponatraemia"],"prefix":"10.1111","volume":"29","author":[{"given":"An","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengcheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and Technology of China  Chengdu 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