Normal saline until perfusion deficits corrected
Then switch to 1/2NS until UOP = >0.5 mL/kg/hr
Target 0.5 mEq/hr correction
Then switch to 1/2NS until UOP = >0.5 mL/kg/hr
Target 0.5 mEq/hr correction
Avoid lowering Na more than 10-15 mEq/L/day (~0.5-1.0 mEq/L/hr initially)
Central DI → Treat with DDAVP
Peds: >180meq/L consider peritoneal dialysis
Free water deficit = (0.6 x wt in kg) x [(serum Na/140) – 1]
Each liter H2O Deficit increases Na by 3-5 meq/L
Hypernatremia
Hyponatremia
Metabolic alkalosis
Hypercapnia
Hyperammonemia
Ketonemia
Lactic acidosis
Anion gap acidosis