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hypernatraemia

hypernatraemia

introduction

  • hypernatraemia may be life threatening if severe, of if sodium level rapidly rises or rapidly falls

aetiology

reduced water intake

  • elderly patients with reduced thirst or ability to drink

water losses

Mx of hypernatraemia

  • if dehydrated with intravascular volume depletion, give initial 0.9% saline to restore intravascular volume, then “free-water” fluid Mx with an aim to slowly correct the hypernatraemia as below

desired rate of correction of serum sodium levels

  • in general, no faster than 0.5mmol/L/hr, or 8-10 mmol/L per day
  • those with severe acute hypernatraemia (documented as occurring over < 24hrs) can be considered for faster correction of 2-3mmol/L/hr for 2-3hrs and no more than 12mmol/L per day
  • monitor electrolyte levels at least 4hrly

measure free water deficit and determine free-water infusion rate

hypernatraemia.txt · Last modified: 2014/07/23 09:01 by gary1