Sodium Correction Rate in Hyponatraemia
Calculates the volume of hypertonic saline (3% NaCl) or normal saline needed to correct hyponatraemia at a safe rate, preventing osmotic demyelination syndrome (ODS).
Score interpretation
Safe sodium correction calculated. Target: ≤ 10–12 mmol/L/24h (≤ 8 mmol/L/24h in high-risk patients).
→ High-risk for ODS: alcoholism, malnutrition, liver disease, hypokalaemia → limit to 8 mmol/L/24h. Use 3% NaCl at calculated rate. Monitor sodium every 2–4h. Stop if target reached.
Symptoms: seizures, coma, herniation. Urgent 3% NaCl bolus required.
→ 3% NaCl 100–150 mL IV bolus over 20 min. Repeat up to 3 times if seizures persist. Target: raise Na⁺ by 4–6 mmol/L acutely to stop symptoms. Then slow correction. ICU admission.
Interpretation bands for the Na⁺ Correction Rate. Apply clinical judgement and local guidance.
References
- Spasovski G, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol. 2014;170(3):G1–47.
- NICE guideline NG29. Intravenous fluid therapy in adults in hospital. 2013 (updated 2017).
Related
Curated clinical cross-links plus same-class fallbacks.
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Potassium chloride with calcium chloride and sodium chloride · Crystalloid IV fluid
- Potassium chloride with calcium chloride sodium chloride and sodium lactate · Balanced crystalloid IV fluid
- Potassium chloride with glucose and sodium chloride · IV fluid (mixed)
- Potassium chloride with sodium chloride · IV fluid (potassium + saline)
- Sodium chloride · Saline IV fluid / replacement
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.