Caution of overdependence on formulas while treating hyponatremia.
Use of online formulas to treat hyponatremia is a common practice. We report here that while using the same goal of correction and type of infusate to treat a patient with hyponatremia, a large discrepancy in infusion rate is obtained from using the 2 commonly available online equations. When the therapy fluid is less concentrated saline (0.9%), Adrogue's formula poses the risk of large amount of volume being administered for only a small change in serum sodium concentration. This may be detrimental especially in patients with congestive heart failure. When the therapy fluid is hypertonic saline (3%), these formulas may result in overly rapid correction. We should, thus, never use these formulas blindly in the management of patients with hyponatremia.
Department of Medicine, Division of Nephrology, St Luke's-Roosevelt Hospital Center, New York, NY, USA. gsandhu@chpnet.org
Gagangeet
G
Sandhu
Eduardo
E
Zouain
Germaine
G
Chan
D000368:Aged; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D007010:Hyponatremia / Q000628:therapy*; D007262:Infusions, Intravenous / Q000379:methods; D012964:Sodium / Q000097:blood; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use*
D012965:Sodium Chloride; D012964:Sodium