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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.