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.