Treatment of hypernatremia

Quick Review From My Notes

1. Treatment of Hypernatremia My Notes By Dr Sahar Salem Sasy

2. Estimate the effect of 1 L of any infusate on serum Na + concentration as follow: Equation 2: Change in serum Na + = ( infusate Na + - serum Na + ) ÷ (TBW + 1) Equation 3: If the infusate contain Na and Ka use the following formula : Change in serum Na + = ([ infusate Na + + infusate K +} – serum Na + ) ÷ (TBW + 1) Equation 2 allows for the estimation of 1 L of any infusate on serum Na + concentration. Equation 3 allows for the estimation of 1 L of any infusate containing Na + and K + on serum Na + .

3. Common infusates and their Na + contents include the following : 5% dextrose in water (D 5 W): 0 mmol /L 0.2% sodium chloride in 5% dextrose in water (D 5 2NS): 34 mmol /L 0.45% sodium chloride in water (0.45NS): 77 mmol /L Ringer's lactate solution: 130 mmol /L 0.9% sodium chloride in water (0.9NS): 154 mmol /L The result will show how much Na will be reduced by 1L infusate (-x)

4. The rate will be calculated as follow : 10 ÷ (x) = (A1)L of solution is required The goal is to reduce the patient’s serum sodium by no more than 10 mmol /L in a 24-hour period (-x ) X 1000 (ml)=(A)ml to convert from L to ml. Add the insensible water loss to calculate the total amount of fluid required (ml or cc) per 24h. A1+(1000 ml to 1500 ml insensible loss )=A2(ml) A2 ÷ 24= A2 ml or cc /24h

5. All The Best