Are there instances when you use a 3% sodium chloride infusion for patients with chronic hyponatremia secondary to SIADH but who are asymptomatic or have only mild symptoms?

One thing about 3% is that properly administered, the Na will rise. I have used it when I just want the PNa to increase ASAP, which for non neurological reasons may be something as simple as allowing the patient to go to the OR (they often have a minimal Na that they will give general anesthesia to) or wanting to discharge for a mild post of pain nausea SIADH that I am pretty certain is transient.

It has been argued that patients with chronic “asymptomatic” hyponatremia are not truly “asymptomatic.” It has been shown that these patients often have subtle cognitive impairment, gait instability, and are at increased risks for bone loss. Chronic hyponatremia has been shown to stimulate osteoclast activity and impair osteoblast function. There may also be mobilization of exchangeable sodium from bone in the setting of chronic hyponatremia, thereby triggering bone resorption to release sodium....