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    Sodium Correction Rate in Hyponatremia and Hypernatremia

    Calculates recommended fluid type, rate and volume to correct hyponatremia slowly (or more rapidly if seizing).
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    The proper rate of correction of hyponatremia is important. Overly rapid correction, particularly in chronic hyponatremia, can lead to osmotic demylination syndrome (ODS), previously known as central pontine myelinolysis (CPM).

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    mEq/L

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    Advice

    Correct hyponatremia carefully. Use with the Sodium Deficit in Hyponatremia calculator which estimates the total amount of sodium that needs to be replaced. Do not forget to correct the hypoonatremia level in hyperglycemic patients with the Sodium Correction for Hyperglycemia calculator. Typically hypertonic solutions are reserved for patients that are overly symptomatic, such as seizures and severe neurologic deficits.

    Formula

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

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

    Facts & Figures

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

    *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.

    Literature

    Dr. Nicolaos E. Madias

    About the Creator

    Nicolaos E. Madias, MD is the chair of the department of medicine at the St. Elizabeth's Medical Center and a professor of medicine, specializing in Nephrology, at Tufts University School of Medicine. He has co-authored over 100 articles published in peer reviewed journals.

    To view Dr. Nicolaos E. Madias's publications, visit PubMed