2 worked examples of how to determine appropriate IV fluid and infusion rates in patients with hypernatremia.

11 thoughts on “Hypernatremia – Examples”

Florian Faehling

Thank you again for your insightful video! Two questions: 1) in your second example, aren't you actually correcting the patient's sodium level with 267 mL/hr of D5W? Wouldn't that correct his sodium level by more then 10 meq/L and thus risk cerebral edema? I wonder if it wouldn't be safer to give saline solution to account for the additional fluid loss 2) why are you calculating the rate of infusion per 12 h and not per 24 hours?Thanks a lot

Darshan Jani

nice video Dr Eric!I am an ICU registrar facing electrolyte imbalances everyday… theoretically this sounds great… but in the ICU, most of my patients either have an Ischaemic heart disease/Dialated Cardiomyopathy/Valvular diseases/Oliguria(unrelated to just hypovolemia)/septic cardiomypathy etc… now it would be impossible to transfuse them with such huge amounts of fluids even though the equations show that it is required. you being a clinician yourself must be facing these problems too…how do you go about it?thanks

eman mahmoud

many thanks 4 you.really it is very helpful.

Idel Fernandez

Hello Dr EricI am studying this, and the exams asked me about the method in which is necessary to calculate free water deficit, in which I cannot understand how to calculate the solute deficit. They say you should give the 24h maintenance + the entire solute deficit + 1/2 of the free water deficit in the first 24h.Then I looked for your videos, which are outstanding, trying to find the explanation; however, you came with other method and during your explanation of the first example you use a volume of 5 to be divided by – 2.2 mEq/L. I do not know what is the reason to take that volume of 5, could you explain me this please? thank you in advance.

Sanesh S

Thanks Dr.Eric.you are the best teacher.

GrosserAndrew5000

DUde, you are the best…. I watch this over and over, and it never gets old…. Love the music (baroque?). Cheers!

Shubha Deep Roy

This was greatly helpful. Thank you Dr Eric for all your efforts.

Strong Medicine

I hope my videos will be helpful. Regarding the above video on hypernat. – when it comes to taking exams, as I mention at the end, most doctors use calculations of free water deficit to calculation fluid repletion rates. I think such calculations are unnecessary and not more accuate, but it could give a slightly different answer than the method I show here. It's prob not a clinically relevant difference, but might make a difference if the person grading you uses the other method. Good luck!

Umut Gök

There is a exam called YDUS for anesthesia sub specialty in Turkey which on Saturday and there will be a lot of questions which you have mentioned in all the videos

Umut Gök

Thanks a lot. I am looking forward to see next video.

Florian FaehlingThank you again for your insightful video! Two questions: 1) in your second example, aren't you actually correcting the patient's sodium level with 267 mL/hr of D5W? Wouldn't that correct his sodium level by more then 10 meq/L and thus risk cerebral edema? I wonder if it wouldn't be safer to give saline solution to account for the additional fluid loss 2) why are you calculating the rate of infusion per 12 h and not per 24 hours?Thanks a lot

Darshan Janinice video Dr Eric!I am an ICU registrar facing electrolyte imbalances everyday… theoretically this sounds great… but in the ICU, most of my patients either have an Ischaemic heart disease/Dialated Cardiomyopathy/Valvular diseases/Oliguria(unrelated to just hypovolemia)/septic cardiomypathy etc… now it would be impossible to transfuse them with such huge amounts of fluids even though the equations show that it is required. you being a clinician yourself must be facing these problems too…how do you go about it?thanks

eman mahmoudmany thanks 4 you.really it is very helpful.

Idel FernandezHello Dr EricI am studying this, and the exams asked me about the method in which is necessary to calculate free water deficit, in which I cannot understand how to calculate the solute deficit. They say you should give the 24h maintenance + the entire solute deficit + 1/2 of the free water deficit in the first 24h.Then I looked for your videos, which are outstanding, trying to find the explanation; however, you came with other method and during your explanation of the first example you use a volume of 5 to be divided by – 2.2 mEq/L. I do not know what is the reason to take that volume of 5, could you explain me this please? thank you in advance.

Sanesh SThanks Dr.Eric.you are the best teacher.

GrosserAndrew5000DUde, you are the best…. I watch this over and over, and it never gets old…. Love the music (baroque?). Cheers!

Shubha Deep RoyThis was greatly helpful. Thank you Dr Eric for all your efforts.

Strong MedicineI hope my videos will be helpful. Regarding the above video on hypernat. – when it comes to taking exams, as I mention at the end, most doctors use calculations of free water deficit to calculation fluid repletion rates. I think such calculations are unnecessary and not more accuate, but it could give a slightly different answer than the method I show here. It's prob not a clinically relevant difference, but might make a difference if the person grading you uses the other method. Good luck!

Umut GökThere is a exam called YDUS for anesthesia sub specialty in Turkey which on Saturday and there will be a lot of questions which you have mentioned in all the videos

Umut GökThanks a lot. I am looking forward to see next video.

HashmeisterThanks for the video Doc :)