使用高濃度生理食鹽水校正低血鈉(網路計算機)

2023-12-01 14:23

網路上有很方便的計算器. 
HYPERTONIC SALINE 3% AND 0.9NS INFUSION RATE CALC

舉例. 70歲男性低血鈉. 體重 70 kg. 目前血鈉 107 meg/L 
血鈉濃度預計補充到 120 

40.9 

下面有文字註解

Hypertonic Saline (3%) Infusion

Hypertonic saline is usually reserved for severe hyponatremia (sodium < 115-120 meq/L).  Look below for a review of hyponatremia.   In severe cases, the maximum sodium increase within the first 24 hours should not exceed 10 to 12 meq/liter  or <20 to 25 meq/L over 48 hours in order to avoid CNS complications (cerebral edema, pontine myelinolysis, seizures) and/or pulmonary edema.  Thereafter, the hypertonic saline is stopped, and the serum sodium is allowed to rise more slowly (eg over several days) in response to continued restriction of free water. In all cases, the serum sodium should be corrected only halfway to normal in the initial 24 hours (120-125 meq/L) to prevent the complications listed above.

每小時輸入 40.9cc 3% saline 連續滴注 26 小時. 

最初 24小時血鈉濃度上升控制在 8-12 mEq/L 

注意. 前 24 小時血鈉濃度上升不要超過 10-12 mEq 
或 48 小時內不要上升超過 20-25 mEq/L 

總共需注射 1063.4 cc 的高張(3%)生理食鹽水

Results

   Infuse 3% hypertonic saline at 40.9 ml/hr (equivalent to 0.5 meq/L/hr serum Na+ increase) for 26.0 hours or less. Sources vary as to the maximum recommended serum sodium increase in a 24hr period - range: 8 to 12 meq/L/24hr. Current selection (previous screen) 12 meq/L/24hr. This should produce the target level requested. Discontinue hypertonic saline at this time and continue depending on the clinical situation water restriction or normal saline infusion. Note: the maximum sodium increase within the first 24 hours should not exceed 10 to 12 meq/liter or <20-25 meq/L over 48 hours. Frequent monitoring of the serum sodium level is necessary during the infusion.

Pharmacy - Total volume required: 1063.4 ml.