For January journal club, we will be tackling some new literature.  In the last 1.5 years there have been 2 separate articles addressing the speed by which hyponatremia is corrected and the associated inpatient mortality.  Previous recommendations have consistently advised that we be judicious and slow in our correction of hyponatremia in order to prevent the dreaded complication of osmotic demyelination syndrome (previously termed central pontine myelinolysis).  2 new articles have called that wisdom into question, Dr. Stansbie and Dr. Potter will lead the discussion on these articles.  Dr. Grill will additionally be addressing an article on the inpatient management of pulmonary embolism, showing a trend in the US towards the use of unfractionated heparin over other alternatives such as direct oral inhibitors and low molecular weight heparin (LMWH).

Stansbie: Seethapathy H, Zhao S, Ouyang T, Passos C, Sarang A, Cheung PW, Waikar SS, Steele DJR, Kalim S, Allegretti AS, Ayus JC, Nigwekar SU. Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis. NEJM Evid. 2023 Oct;2(10):EVIDoa2300107. doi: 10.1056/EVIDoa2300107. Epub 2023 Sep 26. PMID: 38320180. Summary

Potter: Ayus JC, Moritz ML, Fuentes NA, Mejia JR, Alfonso JM, Shin S, Fralick M, Ciapponi A. Correction Rates and Clinical Outcomes in Hospitalized Adults With Severe Hyponatremia: A Systematic Review and Meta-Analysis. JAMA Intern Med. 2025 Jan 1;185(1):38-51. doi: 10.1001/jamainternmed.2024.5981. PMID: 39556338; PMCID: PMC11574719. Summary

Grill: Westafer LM, Presti T, Shieh MS, Pekow PS, Barnes GD, Kapoor A, Lindenauer PK. Trends in Initial Anticoagulation Among US Patients Hospitalized With Acute Pulmonary Embolism 2011-2020. Ann Emerg Med. 2024 Nov;84(5):518-529. doi: 10.1016/j.annemergmed.2024.05.009. Epub 2024 Jun 18. PMID: 38888528; PMCID: PMC11493503. Summary