A Survey of Clinician‐Reported Management of Hypernatremia in the ICU

@article{seitzrasmussen2026survey,
  title = {{A Survey of Clinician‐Reported Management of Hypernatremia in the ICU}},
  author = {Hans Eric Sebastian Seitz‐Rasmussen and Morten H. Bestle and Olav Lilleholt Schjørring and Andrew Ratcliffe and Aoife O'Grady and Jonathan Silversides and Marcus Broman and Peter Bentzer and Pedro Povoa and Johanna Hästbacka and Kristian Strand and Paul Young and Niels Van Regenmortel and Carmen A. Pfortmüller and Manu L. N. G. Malbrain and Ahmad Nasser and Martin Sigurdson and Meint Volbeda and Sine Wichmann and Morten Hylander Møller and Morten Hylander Møller and Emilie Stockholm Bækgaard and Anne Sofie Andreasen and Niels Foldager and Louise Gamstrup Nielsen and Christoffer Sølling and Therese Malmqvist Frederiksen and Thomas Hvidtfeldt Vestergaard and Sebastian Knudsen and Anders Aneman and Mark Plummer and Thomas Kander and Johan Undén and Maria Meirik and Nicklas Oscarsson and Anca Balintescu and Maria Cronhjort and Miklos Lipcsey and Björn Ahlström and Alicia Lind Howell and Johanna Savilampi and Erling Haug Holen and Michael Hahn and Hod Stern and Shirin Kordasti Frisvold and Karl‐Andre Wian and Aasmund Godø and Stephan Balsliemke and Vegard Tørå Dokka and Brendon Sloan and Aaron Corp and Andy Chamberlain and Gary Mills and Anil Hormis and Mike Dean and Tim Felton and Craig Brandwood and Andy Drummond and John Rae and Jerry Nolan},
  journal = {Acta Anaesthesiologica Scandinavica},
  year = {2026},
  month = nov,
  doi = {10.1111/aas.70386},
  url = {https://doi.org/10.1111/aas.70386},
  note = {CC BY-NC-ND 4.0},
}

TY  - JOUR
TI  - A Survey of Clinician‐Reported Management of Hypernatremia in the ICU
AU  - Hans Eric Sebastian Seitz‐Rasmussen
AU  - Morten H. Bestle
AU  - Olav Lilleholt Schjørring
AU  - Andrew Ratcliffe
AU  - Aoife O'Grady
AU  - Jonathan Silversides
AU  - Marcus Broman
AU  - Peter Bentzer
AU  - Pedro Povoa
AU  - Johanna Hästbacka
AU  - Kristian Strand
AU  - Paul Young
AU  - Niels Van Regenmortel
AU  - Carmen A. Pfortmüller
AU  - Manu L. N. G. Malbrain
AU  - Ahmad Nasser
AU  - Martin Sigurdson
AU  - Meint Volbeda
AU  - Sine Wichmann
AU  - Morten Hylander Møller
AU  - Morten Hylander Møller
AU  - Emilie Stockholm Bækgaard
AU  - Anne Sofie Andreasen
AU  - Niels Foldager
AU  - Louise Gamstrup Nielsen
AU  - Christoffer Sølling
AU  - Therese Malmqvist Frederiksen
AU  - Thomas Hvidtfeldt Vestergaard
AU  - Sebastian Knudsen
AU  - Anders Aneman
AU  - Mark Plummer
AU  - Thomas Kander
AU  - Johan Undén
AU  - Maria Meirik
AU  - Nicklas Oscarsson
AU  - Anca Balintescu
AU  - Maria Cronhjort
AU  - Miklos Lipcsey
AU  - Björn Ahlström
AU  - Alicia Lind Howell
AU  - Johanna Savilampi
AU  - Erling Haug Holen
AU  - Michael Hahn
AU  - Hod Stern
AU  - Shirin Kordasti Frisvold
AU  - Karl‐Andre Wian
AU  - Aasmund Godø
AU  - Stephan Balsliemke
AU  - Vegard Tørå Dokka
AU  - Brendon Sloan
AU  - Aaron Corp
AU  - Andy Chamberlain
AU  - Gary Mills
AU  - Anil Hormis
AU  - Mike Dean
AU  - Tim Felton
AU  - Craig Brandwood
AU  - Andy Drummond
AU  - John Rae
AU  - Jerry Nolan
PY  - 2026
DA  - 2026/11/04
JO  - Acta Anaesthesiologica Scandinavica
DO  - 10.1111/aas.70386
UR  - https://doi.org/10.1111/aas.70386
AB  - Background: Hypernatremia is frequent in the intensive care unit (ICU) and is associated with adverse outcomes. Despite its prevalence, robust evidence to guide treatment is lacking, and global practice patterns are largely unknown. We investigated global treatment preferences and clinicians' willingness to enroll patients in a randomized trial to inform its feasibility.  Methods: This international cross‐sectional online survey comprised 20 primarily closed‐ended questions, using five‐point Likert‐scale responses, across four themes: treatment method, threshold, correction rate, and opinion on a proposed trial. Respondents considered a clinical vignette of hypernatremia developing before or during ICU admission, excluding dehydration and chronic causes. It was distributed to ICU physicians worldwide.  Results: The survey was sent to 3053 ICU physicians in 17 countries, with 1051 respondents, yielding a response rate of 34%. Of respondents, 74% were consultants, and 26% were residents. The mean ICU experience was 14 years. Increasing free water intake via enteral route was the most frequently reported treatment strategy (80% reporting “often” or “always”). Moderate hypernatremia (plasma sodium 151–156 mmol/L) was the most frequently reported threshold for initiating correction (533/892, 60%). 45% (396/888) preferred a correction rate of 8–12 mmol/L/day, and 41% (366/888) of < 8 mmol/L/day, with the remainder having no correction rate target or correction rate target of > 12 mmol/L/day. 74% (654/882) reported no barriers to enrolling eligible patients in the proposed trial.  Conclusion: Among ICU physicians, correction of hypernatremia is mostly achieved by increasing free water intake using hypotonic fluids, predominantly via the enteral route. Most clinicians initiate treatment once hypernatremia reaches a moderate level, aiming for a correction rate of < 12 mmol/L/day. Most clinicians expressed willingness to enroll eligible patients in the proposed trial.  Editorial Comment: This survey study aimed to sample physician preferences for treatment of hypernatremia when on their way to or in the ICU. This study sampled respondents in many countries, and based on different phases of treatment and assessment, as well as participant willingness for a future treatment trial.
SN  - 0001-5172
SN  - 1399-6576
ER  -