Ratio Profile: Physiologic Approach to Estimating Appropriate Intravenous Fluid Rate to Manage Hyponatremia in the Syndrome of Inappropriate Antidiuresis

ABSTRACT: A hyponatremic patient with the syndrome of inappropriate antidiuresis (SIAD) gets normal saline (NS), and the plasma sodium decreases, paradoxically. To explain, desalination is often invoked: if urine is more concentrated than NS, the fluid’s salts are excreted while some water is reabsorbed, exacerbating hyponatremia. But comparing concentrations can be deceiving. They should be converted to quantities because mass balance is key to unlocking the paradox. The [sodium] equation can legitimately be used to track all of the sodium, potassium, and water entering and leaving the body. Each input or output “module” can be counterbalanced by a chosen iv fluid so that the plasma sodium stays stable. This equipoise is expressed in terms of the iv fluid’s infusion rate, an easy calculation called

SUBMITTER: Chen S 

PROVIDER: S-EPMC9802565 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature