MDCalc Mobile | Sodium Correction Rate in Hyponatremia

Sodium Correction Rate in Hyponatremia

Calculates recommended fluid type, rate and volume to correct a patient's hyponatremia slowly (or more rapidly if seizing).

*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.

Change in Serum Sodium = (Fluid Sodium - Serum Sodium) / (Total Body Water + 1)
Total Body Water = (Wt in kg * % Water)

Age	Male	Female
Child	0.6	0.6
Adult	0.6	0.5
Elderly	0.5	0.45

Hyponatremia. Adrogué HJ, Madias NE. NEJM, 2000.

Posted in: Critical Care • Nephrology • Renal

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