Sodium Correction Rate in Hyponatremia and Hypernatremia

id

480

full_title

Sodium Correction Rate in Hyponatremia and Hypernatremia

short_title

Sodium Correction Rate in Hyponatremia/Hypernatremia

med_description

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

description

The Sodium Correction Rate for Hyponatremia Calculates recommended fluid type, rate and volume to correct hyponatremia slowly (or more rapidly if seizing).

keywords

Sodium Correction Rate for Hyponatremia, na hyponatremia, na rate, sodium rate, sodium hyponatremia, seizure sodium, na sodium, seizure sodium calc, sodium volume correct, sodium volume, sodium volume seisure, sodium volume calc, hyponatremia, hyponatremia calc, hyponatremia fix, hyponatremia treat, hyponatremia tx

complaint

[ "AMS", "Seizure", "Weakness" ]

formula

Fluid rate, mL/hr = (1000 × rate of sodium correction, mmol/L/hr) / change in serum sodium

Change in serum sodium = (fluid sodium, mmol/L - serum sodium, mmol/L) / (total body water + 1)

Total body water = weight, kg × % body water, defined as follows:

% body water:

Experts recommend correcting no faster than 12 mmol/L/day (0.5mmol/L/hr) to avoid osmotic demylination syndrome (ODS), previously known as central pontine myelinolysis (CPM), 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, and even then, only correcting it at 1-2 mmol/L/hr.

evidence

measurements

[ { "name": "rate_Na_correction", "unit": "rate_Na_correction", "error_min": "0", "error_max": "2", "warn_min": "0.5", "warn_max": "0.5", "conversion": "1", "normal_max_si": "0", "normal_max_us": "0", "normal_min_si": "0", "normal_min_us": "0", "units_si": "mmol/L/hr", "units_us": "mEq/L/hr" }, { "name": "Weight", "unit": "wt", "error_min": "0.5", "error_max": "620", "warn_min": "0.5", "warn_max": "500", "conversion": "0.453592", "normal_max_si": "150", "normal_max_us": "330", "normal_min_si": "1", "normal_min_us": "2", "units_si": "kg", "units_us": "lbs" }, { "name": "Sodium", "unit": "na", "error_min": "100", "error_max": "200", "warn_min": "0", "warn_max": "170", "conversion": "1", "normal_max_si": "145", "normal_max_us": "145", "normal_min_si": "136", "normal_min_us": "136", "units_si": "mmol/L", "units_us": "mEq/L" }, { "name": "Weight", "unit": "wt_nonadult", "error_min": "0.5", "error_max": "600", "warn_min": "0.5", "warn_max": "500", "conversion": "0.453592", "normal_max_si": "0", "normal_max_us": "0", "normal_min_si": "0", "normal_min_us": "0", "units_si": "kg", "units_us": "lbs" } ]

information

refrences

{ "Clinical Practice Guidelines": [], "Manufacturer Website": [], "Original/Primary Reference": [ { "href": "https://pubmed.ncbi.nlm.nih.gov/10824078/", "text": "Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med. 2000;342(21):1581-1589." } ], "Other References": [], "Outcomes": [], "Validation": [], "Validations": [] }

pearls

• 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).

• In most cases, sodium correction should be done in an ICU setting, especially with hypertonic fluids for replacement.

usecase

Use with the Sodium Deficit in Hyponatremia calculator which estimates the total amount of sodium that needs to be replaced.

reasons

next_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 hyponatremia level in hyperglycemic patients with the Sodium Correction for Hyperglycemia calculator.
• Typically, hypertonic solutions are reserved for patients who are overly symptomatic, such as those with seizures and severe neurologic deficits.

next_actions

next_management

diseases

[ "Acid-Base Disturbance", "Hypernatremia", "Hyponatremia" ]

instructions

published

2022-04-21T20:29:43.081Z

purpose

[ "Treatment", "Formula" ]

search_terms

[ "na" ]

seo

{ "keywords_en": "Sodium Correction Rate for Hyponatremia, na hyponatremia, na rate, sodium rate, sodium hyponatremia, seizure sodium, na sodium, seizure sodium calc, sodium volume correct, sodium volume, sodium volume seisure, sodium volume calc, hyponatremia, hyponatremia calc, hyponatremia fix, hyponatremia treat, hyponatremia tx", "meta_description_en": "The Sodium Correction Rate for Hyponatremia Calculates recommended fluid type, rate and volume to correct hyponatremia slowly (or more rapidly if seizing)." }

specialty

[ "Critical Care", "Critical Care (Neurologic)", "Critical Care (Pediatric)", "Emergency Medicine", "Hospitalist Medicine", "Nephrology", "Neurology", "Pediatrics", "Pharmacy" ]

departments

[ "Endocrine and Metabolic", "Neurologic", "Renal" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 50, "short_title_en": "Sodium Correction for Hyperglycemia", "slug": "sodium-correction-hyperglycemia" }, { "calcId": 95, "short_title_en": "Sodium Deficit in Hyponatremia", "slug": "sodium-deficit-hyponatremia" }, { "calcId": 113, "short_title_en": "Free Water Deficit in Hypernatremia", "slug": "free-water-deficit-hypernatremia" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "endocrine", "neurology", "urology" ]

cleaned_use

[ "Use with theSodium Deficit in Hyponatremiacalculator which estimates the total amount of sodium that needs to be replaced." ]

pub

true