Water deficit replacement in hypernatremia management

[@hemas1550]

Thanks Doctor. Very helpful information. you rock 🎉

[@aliata3797]

Thanks doc! Really great concept explaining.
God bless you

[@Hospitalista]

Glad it was helpful!

[@andromeda6985]

Great video👍

[@Hospitalista]

Thanks 👍

[@majorymunakampe5840]

I haven’t understood on water deficit on the calculation 0.5 and 0.107 where are we getting it from? In children what do we use?

[@hemas1550]

Lord Jesus bless you

[@BlueSky-lb8fw]

Why do you think that there was a treatment delay? Since 145 is upper normal limit of Na.

[@Hospitalista]

The patient was intubated, he is unable to drink water, mechanical ventilation means excessive insensible water losses, Na of 145 is a sign this patient is in need for free water, the goal is to prevent hypernatremia, to be proactive not reactive!

[@BlueSky-lb8fw]

@@Hospitalista aahh now I get it. Thank you for the reply and the great video.

[@saraelsayed4412]

I have a question please- Why use normal saline to resuscitate unstable patients if sodium is high then use hypotonic solution later? Why cant we use hypotonic solution to resuscitate in this case?

[@Hospitalista]

That's a good question! Resuscitation means restoring the intravascular volume and isotonic solutions are the ideal ones for resuscitation as they stay extracellularly unlike hypotonic solutions which shift intracellularly! The hypernatremia may worsen initially but stabilizing the patient takes priority. I will soon have dedicated videos on IVF resuscitation.

[@saraelsayed4412]

@@Hospitalista awesome thank you!

[@majorymunakampe5840]

Am not understanding where the 0.5 and 0.107 coming from? And in children what figures do we use?