section name header

Table 1-2

Correction of Hypernatremia

H2O Deficit

1. Estimate TBW: 50-60% body weight (kg) depending on body composition

2. Calculate free-water deficit: [(Na+ - 140)/140] × TBW

3. Administer deficit over 48-72 h

Ongoing H2O Losses

4. Calculate free-water clearance, CeH2O:

where V is urinary volume, UNa is urinary [Na+], UK is urinary [K+], and SNa is serum [Na+].

Insensible Losses
5. ~10 mL/kg per day: less if ventilated, more if febrile
Total
6. Add components to determine H2O deficit and ongoing H2O loss; correct the H2O deficit over 48-72 h and replace daily H2O loss.

Abbreviation: TBW, total-body water.