To the Editor: We agree with Palmer and Clegg (Oct. 5 issue)1 that improper treatment of hyponatremia in patients with liver disease can produce cerebral demyelination, as reported by us2 and others. Moreover, another factor promoting demyelination is a hypoxic or anoxic episode before treatment of hyponatremia.2 In animals with normonatremia, hypoxia produces demyelination.3 However, a safe approach for the therapy of hyponatremic encephalopathy in patients with liver disease should be revisited. In our practice, we have used a 100-ml bolus of 3% saline rather than a continuous infusion.4 This can be repeated one or two times in sequential fashion . . .

中文翻译：

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慢性酒精使用障碍中的电解质紊乱

致编辑：我们同意 Palmer 和 Clegg（10 月 5 日号）1 的观点，即肝病患者低钠血症治疗不当会导致脑脱髓鞘，正如 us2 和其他人报道的那样。此外，另一个促进脱髓鞘的因素是低钠血症治疗前的缺氧或缺氧发作。2 在正常钠血症的动物中，缺氧会导致脱髓鞘。3 然而，应重新审视治疗肝病患者低钠性脑病的安全方法。在我们的实践中，我们使用 100 毫升 3% 盐水推注，而不是连续输注。4 这可以按顺序重复一到两次。。。