Daniel Shepshelovich
Columbia University, NY·Medicine & Clinical Research
Hypernatremia means the blood's sodium concentration is too high, which signals that the body is short of water. It is common in hospitalized patients and dangerous: for severe cases, reported mortality runs from 30% to 70%.
- Fields
Medicine & Clinical Research
Physiology
- Topics
hypernatremia
electrolyte disorders
serum sodium
- Grants
- 1 known grant, through Apr 2029
What they work on
- Determine the feasibility of identifying, consenting and randomizing adults with severe hypernatremia (serum sodium ≥155 mEq/L) to rapid hydration versus standard care in a single-center pilot trial of 80 patients.
- Test whether a personalized, weight-based intravenous rapid hydration protocol targeting 18 mEq/L per day can be delivered with high fidelity, assessed twice daily with real-time correction of protocol deviations.
- Monitor neurological safety of rapid correction using twice-daily Glasgow coma scale and brief confusion assessment method (bCAM) scoring, modified Rankin scale assessments and brain imaging to exclude cerebral edema.
- Collect preliminary efficacy and safety data — 30-day survival, length of hospitalization, and neurological and cardiopulmonary adverse events — to inform the design and power of a subsequent multicenter randomized trial.
More about the research
Standard practice is to correct it slowly with dilute intravenous fluids, holding the rate below about 0.5 mEq/L per hour or 10 mEq/L per day, out of concern that correcting faster could cause the brain to swell (cerebral edema) and produce neurological injury. In adults, that cautious rule is not supported by clinical trial evidence, and there are no convincing reports of neurological harm in patients who were corrected rapidly. Several retrospective studies, the largest of them published by this investigator, found that rapidly corrected patients had significantly lower mortality with no neurological complications. Whether the current recommendation strikes the right balance between safety and harm is therefore unknown.
Why it matters
Severe hypernatremia is common in hospitals and frequently fatal, yet the slow-correction rule guiding its treatment rests on theory rather than trial evidence. If rapid, weight-based rehydration proves feasible and safe, it could set up a multicenter trial powered to test whether it improves 30-day survival and shortens hospital stays for these patients, potentially changing how an everyday electrolyte emergency is managed.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
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The school
Columbia University: 89 labs on PI Pages, $1.4B a year on research, 625 research doctorates a year.
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