Diagnosis and Differential Diagnosis of Hypotonic Hyponatremia

Appendix 3|Search Strategies

Diagnosis and differential diagnosis of hypotonic hyponatremia We conducted a combined search for diagnostic questions 1 and 2.

1. In patients with hypotonic hyponatraemia, how sensitive and or specific are various 'diagnostic strategies' in comparison with a gold reference standard of sodium challenge in differentiating hypovolemic from euvolaemic hyponatraemia?

2. In patients with hypotonic hyponatraemia, how sensitive and or specific are various 'diagnostic strategies' in comparison with a gold reference standard of expert panel diagnosis in differentiating hypovolemic from euvolaemic hyponatraemia?

Cochrane Library 1. MeSH descriptor: [Hyponatremia] explode all trees 2. hyponatr?emi* 3. MeSH descriptor: [Inappropriate ADH Syndrome] explode all trees 4. #1 or #2 or #3 5. MeSH descriptor: [Hypovolemia] this term only 6. MeSH descriptor: [Hypotension] this term only 7. MeSH descriptor: [Hypotension, Orthostatic] explode all trees 8. MeSH descriptor: [Tachycardia] explode all trees 9. MeSH descriptor: [Dehydration] explode all trees 10. capillary refill 11. MeSH descriptor: [Sodium] explode all trees 12. MeSH descriptor: [Urea] this term only 13. MeSH descriptor: [Uric Acid] this term only 14. MeSH descriptor: [Osmolar Concentration] this term only 15. MeSH descriptor: [Uric Acid] this term only 16. MeSH descriptor: [Osmolar Concentration] explode all trees 17. skin near/3 turgor 18. urin* near/5 sodium 19. fraction* near/3 sodium 20. excret* near/3 sodium 21. urea or ureum or BUN 22. uric acid 23. osmolalit* 24. MeSH descriptor: [Isotonic Solutions] this term only 25. (isotonic or normal) near/3 (saline or sodium or NaCL) 26. MeSH descriptor: [Vasopressins] explode all trees 27. vasopressin 28. copeptin* 29. #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 30. #4 and #29 31. #4 and #29

MEDLINE 1. Hyponatremia/ 2. hyponatr?emi*.tw. 3. Inappropriate ADH Syndrome/ 4. or/1-3 5. Hypovolemia/ 6. hypotension/ or hypotension, orthostatic/ 7. Tachycardia/ 8. Dehydration/ 9. (skin adj3 turgor).tw. 10. capillary refill.tw. 11. Sodium/ur [Urine] 12. Urea/bl, ur [Blood, Urine] 13. Uric Acid/bl, ur [Blood, Urine] 14. exp Osmolar Concentration/ 15. (urin* adj5 sodium).tw. 16. ((fraction* or excret*) adj3 sodium).tw. 17. (urea or ureum or BUN).tw. 18. uric acid.tw. 19. osmolalit*.tw. 20. Isotonic Solutions/ 21. ((isotonic or normal) adj3 (saline or sodium or NACL)).tw. 22. expVasopressins/ 23. vasopressin*.tw. 24. copeptin*.tw. 25. or/5-24 26. 4 and 25 27. limit 26 to "diagnosis (sensitivity)" Acute and chronic treatment of hypotonic hyponatraemia 1. In patients with hypotonic hyponatraemia, which treatments are effective in improving outcomes?

Cochrane Library 1. MeSH descriptor: [Hyponatremia] this term only 2. hyponatremi* or hyponatraemi* 3. MeSH descriptor: [Inappropriate ADH Syndrome] explode all trees 4. #1 or #2 or #3 5. MeSH descriptor: [Hypertonic Solutions] this term only 6. MeSH descriptor: [Saline Solution, Hypertonic] this term only 7. MeSH descriptor: [Isotonic Solutions] this term only 8. (hyponatremi*) or (hyponatraemi*) 9. #5 or #6 or #7 or #8 10. MeSH descriptor: [Urea] this term only 11. (urea or ureum) 12. #10 or #11 13. MeSH descriptor: [Demeclocycline] explode all trees 14. (demeclocyclin*) 15. #13 or #14 16. MeSH descriptor: [Lithium] explode all trees 17. MeSH descriptor: [Lithium Carbonate] explode all trees 18. MeSH descriptor: [Lithium Compounds] this term only 19. lithium 20. #16 or #17 or #18 or #19 21. MeSH descriptor: [Mannitol] explode all trees 22. mannitol 23. MeSH descriptor: [Diuretics, Osmotic] this term only 24. #21 or #22 or #23 25. MeSH descriptor: [Diuretics] this term only 26. MeSH descriptor: [Ethacrynic Acid] this term only 27. MeSH descriptor: [Sodium Potassium Chloride Symporter Inhibitors] explode all trees 28. loop diuretic* 29. furosemid* 30. bumetanid* 31. ethacr?nic acid 32. #25 or #26 or #27 or #28 or #29 or #30 or #31 33. MeSH descriptor: [Deamino Arginine Vasopressin] this term only 34. desmopressin* 35. DDAVP* 36. #33 or #34 or #35 37. MeSH descriptor: [Phenytoin] this term only 38. phenytoin* 39. #37 or #38 40. MeSH descriptor: [Receptors, Vasopressin] this term only 41. MeSH descriptor: [Benzazepines] this term only 42. MeSH descriptor: [Arginine Vasopressin] explode all trees 43. tolvaptan* OR lixivaptan* OR mozavaptan* OR satavaptan* OR conivaptan* 44. (VPA) near/2 (985) 45. #40 or #41 or #42 or #43 or #44 46. MeSH descriptor: [Glucocorticoids] explode all trees 47. MeSH descriptor: [Mineralocorticoids] explode all trees 48. MeSH descriptor: [Hydrocortisone] explode all trees 49. glucocorticoid* 50. mineralocorticoid* 51. hydrocortison* 52. fludrocortison* 53. #46 or #47 or #48 or #49 or #50 or #51 or #52 54. #4 and #9 55. #4 and #12 56. #4 and #15 57. #4 and #20 58. #4 and #24 59. #4 and #32 60. #4 and #36 61. #4 and #39 62. #4 and #45 63. #4 and #53 64. fluid* OR water 65. restrict* OR limit* 66. #64 and #65 67. #4 and #66

MEDLINE 1. Hyponatremia/ 2. hyponatr?emia*.tw. 3. Inappropriate ADH Syndrome/ 4. or/1-3 5. Hypertonic Solutions/ 6. Saline Solution, Hypertonic/ 7. Isotonic Solutions/ 8. ((hypertonic or isotonic) adj3 (NACL or saline or sodium)).tw. 9. or/5-8 10. Urea/ 11. (urea or ureum).tw. 12. or/10-11 13. Demeclocycline/ 14. demeclocyclin*.tw. 15. 13 or 14 16. Lithium/ 17. Lithium Carbonate/ 18. Lithium Compounds/ 19. lithium.tw. 20. or/16-19 21. exp Mannitol/ 22. mannitol.tw. 23. Diuretics, Osmotic/ 24. or/21-23 25. Diuretics/ 26. Ethacrynic Acid/ 27. exp Sodium Potassium Chloride Symporter Inhibitors/ 28. loop diuretic*.tw. 29. furosemide.tw. 30. bumetanide.tw. 31. ethacr?nic acid.tw. 32. or/25-31 33. Deamino Arginine Vasopressin/ 34. Desmopressin*.tw. 35. DDAVP*.tw. 36. or/33-35 37. Phenytoin/ 38. phenytoin*.tw. 39. 37 or 38 40. Receptors, Vasopressin/ 41. Benzazepines/ 42. Arginine Vasopressin/ai [Antagonists & Inhibitors] 43. tolvaptan*.tw. 44. lixivaptan*.tw. 45. mozavaptan*.tw. 46. satavaptan*.tw. 47. conivaptan*.tw. 48. (VPA adj2 "985").tw. 49. or/40-48 50. exp Glucocorticoids/ 51. exp Mineralocorticoids/ 52. exp Hydrocortisone/ 53. glucocorticoid*.tw. 54. mineralocorticoid*.tw. 55. hydrocortison*.tw. 56. fludrocortison*.tw. 57. or/50-56 58. ((water or fluid*) adj4 (restrict* or limit*)).tw. 59. 9 or 12 or 15 or 20 or 24 or 32 or 36 or 39 or 49 or 57 or 58 60. 4 and 59 61. animals/ not (humans/ and animals/) 62. 60 not 61 63. limit 62 to (comment or editorial or letter) 64. 62 not 63 65. (4 and 9) not 61 66. (4 and 12) not 6 67. (4 and 15) not 61 68. (4 and 20) not 61 69. (4 and 24) not 61 70. (4 and 32) not 61 71. (4 and 36) not 61 72. (4 and 39) not 61 73. (4 and 49) not 61 74. (4 and 57) not 61 75. (4 and 58) not 61 76. limit 65 to (comment or editorial or letter) 77. limit 66 to (comment or editorial or letter) 78. limit 67 to (comment or editorial or letter) 79. limit 68 to (comment or editorial or letter) 80. limit 69 to (comment or editorial or letter) 81. limit 70 to (comment or editorial or letter) 82. limit 71 to (comment or editorial or letter) 83. limit 72 to (comment or editorial or letter) 84. limit 73 to (comment or editorial or letter) 85. limit 74 to (comment or editorial or letter) 86. limit 75 to (comment or editorial or letter) 87. 65 not 76 88. 66 not 77 89. 67 not 78 90. 68 not 79 91. 69 not 80 92. 70 not 81 93. 71 not 82 94. 72 not 83 95. 73 not 84 96. 74 not 85 97. 75 not 86

Question 2. In hyponatreamia, does the rate of correction influence outcomes?

Cochrane Library 1. MeSH descriptor: [water-electrolyte Imbalance] this term only 2. MeSH descriptor: [Hyponatremia] this term only 3. MeSH descriptor: [Inappropriate ADH Syndrome] this term only 4. Hyponatremi* or hyponatraemia* 5. Demyelinati* or myelinolysi* 6. #1 or #2 or #3 or #4 or #5

MEDLINE 1. Hyponatremia/ 2. Inappropriate ADH Syndrome/ 3. Water Intoxication/ 4. hyponatr?emia$.tw. 5. Water-Electrolyte Balance/ 6. or/1-5 7. Myelinolysis, Central Pontine/ 8. Demyelinating Diseases/ 9. Pons/pa [Pathology] 10. Brain Damage, Chronic/ 11. myelinol?si$.tw. 12. demyelinati$.tw. 13. ODS.tw. 14. CPM.tw. 15. or/7-14 16. 6 and 15 17. myelinol?si$.ti. 18. 16 or 17