Hypertonic Saline 3% and Normal Saline Infusion Calculator

Custom Saline Calculator

Hypertonic and Normal Saline Infusion Calculator
TARGET VALUES
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References / Background material

WEIGHT / GENDER / INITIAL SODIUM LEVEL

Patient weight:

Current Sodium (Na+) level: meq/L

TARGET VALUES

All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. This Service is intended to be used for informational purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. GlobalRPH does not directly or indirectly practice medicine or provide medical services and therefore assumes no liability whatsoever of any kind for the information and data accessed through the Service or for any diagnosis or treatment made in reliance thereon.

Target sodium level (Should be greater than value entered above): meq/L
Maximum rate of increase:

(Note: infusion rates will be calculated for normal saline and hypertonic saline in this section. This program simply calculates values and does not determine whether the generated values are clinically appropriate.)

Important notes regarding maximum rate of increase

"Most reported cases of osmotic demyelination occurred after rates of correction that exceeded 12 mmol per liter per day were used, but isolated cases occurred after corrections of only 9 to 10 mmol per liter in 24 hours or 19 mmol per liter in 48 hours. After weighing the available evidence and the all-too-real risk of overshooting the mark, we recommend a targeted rate of correction that does not exceed 8 mmol per liter on any day of treatment. Remaining within this target, the initial rate of correction can still be 1 to 2 mmol per liter per hour for several hours in patients with severe symptoms. Should severe symptoms not respond to correction according to the specified target, we suggest that this limit be cautiously exceeded, since the imminent risks of hypotonicity override the potential risk of osmotic demyelination. Recommended indications for stopping the rapid correction of symptomatic hyponatremia (regardless of the method used) are the cessation of life-threatening manifestations, moderation of other symptoms, or the achievement of a serum sodium concentration of 125 to 130 mmol per liter (or even lower if the base-line serum sodium concentration is below 100 mmol per liter)."¹

References:

1. Adrogue HJ, Madias NE. Hyponatremia. N Engl J Med. 2000 May 25;342(21):1581-9.

2. Arieff AI, Ayus JC. Pathogenesis of hyponatremic encephalopathy: current concepts. Chest 1993;103(2):607-10

3. Ayus JC, Arieff AI. Pathogenesis and prevention of hyponatremic encephalopathy. Endocrinol Metab Clin North Am. 1993 Jun;22(2):425-46.

4. own RG. Disorders of water and sodium balance.
Postgrad Med. 1993 Mar;93(4):227-8, 231-4, 239-40.

5. Ellis SJ. Extrapontine myelinolysis after correction of chronic hyponatraemia with isotonic saline. Br J Clin Pract. 1995 Jan-Feb;49(1):49-50.

6. Engquist A. From plasma [Na+] to diagnosis and treatment.
Acta Anaesthesiol Scand Suppl. 1995;107:273-9.