3% HYPERTONIC Sodium Chloride (NaCl)
|A discussion with a consultant MUST occur BEFORE therapy with 3% HYPERTONIC Sodium Chloride is initiated.|
- An electrolyte supplement
- 3% Hypertonic NaCl should only be used for Emergency treatment of severe hyponatremia
- Expansion of the extracellular fluid compartment in cases of hypovolemia and low blood pressure should be done with 0.9% NaCl (normal saline.)
("Isotonic", "Normal Saline")
- Sodium toxicity is almost always related to how fast a sodium deficit is corrected.
- Hypernatremia, edema
- Too rapid an administration may result in an increase in serum osmolality, resulting in CNS hemorrhage.
- administer slowly (see below under "Replacement of Deficit Dose")
- 3% Hypertonic NaCl must be diluted before administration, or 'Y'd" with another IV solution
- the oral solution should always be diluted, mixed with oral feeds
Replacement of Deficit Dose:
|mmol Na needed =
[Desired Serum Na (mmol/L) - Actual Serum Na (mmol/L)] x Weight (kg) x 0.6
- Maximum Rate : 1 mmol/kg/h (the slower the rate the better to minimize sudden alterations in serum osmolality)
- Preterm : 2 - 8 mmol/kg/d
- Term : 3 - 4 mmol/kg/d
|3% Hypertonic NaCl ( 0.5 mmol / mL)||: 115 mL IV bags for IV use (must be DILUTED or "Y"d with another IV solution)||: amber bottles for oral use (DILUTE or MIX with oral feeds)|
- Pediatric Dosage Handbook,11th Edition, Taketomo CK, Hodding JH, Jraus DM (Editors), Lexicomp, APHA, Hudson, Ohio.
- Neonatal Medications and Nutrition, 3rd Edition, Zenk KE, Sills JH, Koeppel RM, NICU Link, Santa Rosa, California.
- Neonatal and Pediatric Pharmacology, 3rd Edition, Yaffe SJ, Aranda JV (Editors), Lippincott Williams and Wilkins, New York
NEW : September 2005