Units: US SI

Sodium Correction Rate in Hyponatremia

Is patient female? Yes
Age Child
Adult
Elderly
Normal Pt Weight lbs
Serum Na mmol/L
Type of Fluid 3% Saline (513 Na mmol/L)
Normal Saline (154 Na mmol/L)
Ringer's Lactate (130 Na mmol/L)
1/2 Normal Saline (77 Na mmol/L)
Fluid Rate to Increase Sodium by 0.5 mmol/L/hr ml/hr of selected fluid
Fluid Rate to Increase Sodium by 1 mmol/L/hr* ml/hr of selected fluid
Fluid Rate to Increase Sodium by 2 mmol/L/hr* ml/hr of selected fluid

Change in Serum Sodium = (Fluid Sodium - Serum Sodium) / (Total Body Water + 1)

Total Body Water = (Wt in kg * % Water)

AgeMaleFemale
Child0.60.6
Adult0.60.5
Elderly0.50.45

*Experts recommend correcting no faster than 12 mmol/L/day (0.5mmol/L/hr) to avoid central pontine myelinolysis (first calculation), and only correcting it faster — and only using hypertonic (3%) saline — if the patient is seriously symptomatic at a rate of 1-2 mmol/L/hr (second/third calculations), and even then, only correcting it at 1-2 mmol/L/hr for <3 hours.

Posted in: Critical Care • Nephrology • Renal

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