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https://www.aafp.org/afp/2015/0301/p299.html#:~:text=In%20patients%20with%20severe%20symptomatic%20hyponatremia%2C%20the%20rate,saline%20can%20be%20given%20to%20correct%20severe%20hyponatremia.
https://epomedicine.com/clinical-medicine/hyponatremia-correction-practical-approach/
For all patients with hyponatremia, the goal is 6 mEq/L during the initial 24 hours. For those with severe symptoms (seizure, severe delirium, …
https://www.aafp.org/afp/2015/0301/p299.html
https://pubmed.ncbi.nlm.nih.gov/26434962/
Patients were classified as having optimally or nonoptimally corrected hyponatremia at 24 …
https://pulmccm.org/critical-care-review/hyponatremia-corrected-too-quickly-and-dangerously-in-many-patients/
Over half of patients had their sodium corrected faster than experts recommend (>6 mEq/L in 24 hours). In more than 40%, the rate of correction was above what is considered dangerous (>8 mEq/L in 24 hours). Eight patients (0.5% of the entire cohort) developed new osmotic demyelination, as diagnosed by MRI.
https://www.mdcalc.com/sodium-correction-rate-hyponatremia-hypernatremia
Rate of sodium correction To avoid central pontine myelinolysis, sodium should not be corrected faster than 0.5 mmol/L/hr unless patient is seriously symptomatic mEq/L/hr
https://cjasn.asnjournals.org/content/14/5/656
Rapid hypernatremia correction was defined as an overall serum sodium correction rate of >0.5 and ≤0.5 mmol/L per hour was considered slower hypernatremia correction rate. Additionally, we did several subanalysis with varying hypernatremia correction rates of >8, >10, and >12 mmol/L per 24 hours.
https://cjasn.asnjournals.org/content/15/2/282
Overly rapid correction of hyponatremia is defined as a plasma sodium correction rate exceeding the recommended limits, but controversy still exists about what those limits are. Two common limits used are ( 1) >10–12 mEq/L in the first 24 hours and >18 mEq/L in the first 48 hours; and ( 2) >8 mEq/L in any 24-hour period.
https://www.mdcalc.com/sodium-correction-hyperglycemia
The Sodium Correction for Hyperglycemia Calculates the actual sodium level in patients with hyperglycemia. This is an unprecedented time. It is the dedication of healthcare workers that will lead us through this crisis. Thank you for everything you do. COVID-19 Resource Center.
http://sinaiem.org/foam/hypernatremia/
STEP 2: Choose rate of correction. Acute hypernatremia (<48 hours) Goal to lower acutely to 145mmol/L within 24 hours; Chronic hypernatremia (>48 hours) Goal lower maximum 10mEq/L in 24 hours (0.5mEq/L/hour) The rate should not exceed this to avoid cerebral edema; Re-check sodium every 2 hours; Step 3: Calculate Fluid Repletion. Acute (< 48 hours)
http://pathlabs.rlbuht.nhs.uk/hyponatraemia.pdf
• Start with normal saline (0.9%) at rate so that serum Na increases by 0.5mmol/L/hour. Overall increase in serum Na should be 10mmol/L during the first 24 hours additional 8mmol/L for every 24 hours or 18mmol/L in 48hours • Continue till serum Na reaches 130mmol/L
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