Must have sufficient confidence that the symptoms are caused by<unk> ; see Clinical Features for definition of categories.
Adults:
Aim for a 5 mmol/l per 24-h increase in serum sodium concentration
Limit increase to 10 mmol/l in the first 24 h (8 mmol/l during every 24 h thereafter), until a serum sodium concentration of 130 mmol/l is reached
Adults:
Aim for a 5 mmol/l per 24-h increase in serum sodium concentration
Limit increase to 10 mmol/l in the first 24 h (8 mmol/l during every 24 h thereafter), until a serum sodium concentration of 130 mmol/l is reached
Adults:
Each 100 mL will raise sodium by ~2 mmol/l
In general, 200-400 mL of 3% hypertonic saline is reasonable dose in most adult patients with severe symptomatic<unk> , which may be given IV over 1-2 hr until resolution of seizures.
Sodium bicarbonate should be given slowly (each ampule over 5-10 minutes).  Bicarbonate is contraindicated in patients with metabolic alkalosis.
Pediatrics:
2 mL/kg  of 3% over 10-60 minutes can be infused with a repeat of up to 3 times.
Hyponatremia
Thiazide diuretic use
Hypernatremia
Na-wasting nephropathy 
Hypercapnia
Osmotic diuresis 
Hypermagnesemia
Aldosterone deficiency