SODIUM CHLORIDE 3%

Hyponatremia
Serum sodium <125 mmol/L and no symptoms:
1. Sodium (mmol) required to correct to target of 125 mmol/L = 0.6 x weight (kg) x (125 - current serum sodium).
2. Volume of sodium chloride 3% needed (mL) = sodium required (mmol) / 0.513 mmol Na/mL.
3. Administer sodium chloride 3% IV centrally at a maximum rate of 0.5 - 1 mmol/kg/hour (1 - 2 mL/kg/hour)
or 100 mL/hour.
Emergency correction of sodium when patient having symptoms (eg. seizures):
Administer the calculated dose, up to a maximum of 6 mL/kg, IV over a period of 60 minutes.

Critical Care Protocol for the Management of Severe Head Injuries:
1 - 2.5 mmol/kg/dose (2 - 5 mL/kg/dose) IV over 10 minutes. May repeat PRN.
Aim to maintain serum sodium less than 160 mmol/L.

Bronchiolitis:
4 mL inhaled via nebulizer Q8H.

Sodium Chloride replacement, Hypertonic solution

ampoule for inhalation: 3% Sodium Chloride in 4 mL ampoule

injection: 3% sodium chloride (0.513 mmol/mL) (250 mL)

If serum sodium is less than 140 mmol/L, 3% NaCl should be used for management of increased ICP.  If serum sodium is greater than 140 mmol/L, 3% NaCl or mannitol could be considered for management.

Evidence suggest 3% NaCl may be the preferred treatment for increased ICP due to multisystem trauma and cerebral edema from DKA.

3% sodium chloride 5 mL/kg is the equivalent dose of 20% mannitol 1 gram/kg.

Nebulized hypertonic saline no longer recommended for bronchiolitis as studies have shown it is ineffective.

Bronchospasm is a rare adverse effect of hypertonic saline when used for bronchiolitis.

Do not use injection for nebulization.

2022-09-11 00:39:42