Are there instances when you recommend central line access when treating a patient using 3% sodium chloride for management of severe hyponatremia?  

At UCLA, our hospital policy allows for the administration of 3% sodium chloride via a peripheral intravenous catheter at infusion rates up to 50 mL/hr (Perez & Figueroa, PMID 28471928, Jones et al., PMID 27965228, Mesghali et al., PMID 30745195). Moreover, a prospective, observational study dem...

You do not need a central line for 3%, but it took almost an act of god to get our hospital to change it (the head of the pharmacy committee is a nephrologist!). Jones et al., PMID 27965228 Perez & Figueroa, PMID 28471928