Hypotonic hyponatremia dramatic increase the serum sodium concentration and place the patient at risk for so-called "central pontine myelinolysis" (CPM). That disorder is characterized by major neurologic damage, often of a permanent nature. Because of the risk of CPM, people with low volume hyponatremia may eventually require water infusion as well as volume replacement. Doing so lessens the chance of a too rapid increase of the serum sodium level as blood volume rises and ADH levels fall. In people who are volume depleted, i.e., their blood volume is too low, ADH secretion is increased, since volume depletion is a potent stimulus for
Human serum albumin trauma, burns and surgery patients. A Cochrane systematic review of 37 trials found no evidence that albumin, compared with cheaper alternatives such as saline, reduces the risk of dying. Human serum albumin has been used as a component of a frailty index. It has not been shown to give better results than other fluids when used simply to replace volume, but is frequently used in conditions where loss of albumin is a major problem, such as liver disease with ascites. Human serum albumin may be used to potentially reverse drug/chemical toxicity by binding to free drug/agent. (Tatlow, D, Poothencheri, S,