Table 4 Pros and cons of adjusting sodium concentration by methods
Method | Pros | Cons | Example calculation |
|---|---|---|---|
Adding sodium to CRRT solution bags | No extra solutions needed No extra volume added to the patient | Once added, cannot change the sodium concentration of the bag Requires pharmacy services for compounding of solutions | Adding 10Â mL/20Â mL of 23.4% sodium solution to a 5 L CRRT bag with sodium concentration of 140Â mmol/L raises the sodium level to 148/156Â mmol/L, respectively |
Delivering hypertonic sodium solution through the CRRT machine as post-filter replacement fluid | Volume of the solution accounted by CRRT device Easy to adjust the rate of administering hypertonic sodium solution | Requires a CRRT device and a CRRT modality that allows for post-filter replacement fluid | 3% infusion rate = [(target Na – 140 mmol/L)/(513 mmol/L – target Na)] × effluent rate in mL/h |
Delivering hypertonic sodium solution as a separate infusion through central venous catheter | Easy to adjust the rate of administering hypertonic sodium solution It can be stopped independently of CRRT at any time | Rapid change in serum sodium concentration may occur (e.g., when CRRT is unexpectedly discontinued) Additional volume of hypertonic sodium solution is administered to the patient | 3% infusion rate = [(target Na – 140 mmol/L)/(513 mmol/L – target Na)] × effluent rate in mL/h |