Do you have different 24 hour serum sodium correction targets for patients with severe, moderate, and mild hyponatremia?

It is known that overly rapid correction is significantly more likely to cause osmotic demyelination syndrome (ODS) in patients with more severe hyponatremia, particularly when initial serum sodium is ≤105 mmol/L. Since transcellular water movement is mediated by changes in osmolality across the cell membrane, a given increase in serum osmolality will induce greater transcellular water shift in patients with lower serum osmolality. Current evidence recommends that correction of hyponatremia should be less than 6 to 8 mmol/L in a 24-hour period. In patients with severe hyponatremia and significantly low serum osmolality, I would limit the rate of correction to 6 mmol/L rather than 8 mmol/L in 24 hours.