The sodium correction calculator calculates the serum sodium change per liter and the sodium replacement fluid flow rate based on the patient’s weight, serum sodium concentration, the desired rise in serum sodium, and the characteristics of the chosen fluid. Continue reading to learn about the salt replacement formula we utilized. We strive to make our calculators as accurate and dependable as possible. Before giving any medications to your patients, be sure you know the correct dosage.
Why does hyperglycemia affect sodium levels?
A reduction in serum sodium concentration relates to hyperglycemia. Along the osmotic gradient, water travels from the intracellular to extracellular spaces, decreasing serum sodium levels. As a result, most hyperglycemic individuals are moderately hyponatremic. However, patients with normal or even high blood sodium levels we occasionally see when they develop osmotic diuresis due to a lack of appropriate fluid replenishment. Particularly in older people with a weakened thirst mechanism or limitation to fluids.
Patients with hyponatremia may be ignored during severe hyperglycemia since hyperglycemia can lower salt content. Therefore, according to our hypothesis, the corrected blood sodium level for severe hyperglycemia should be a predictive indicator for clinical outcomes in severe hyperglycemic patients. As a result, we undertook this study to see how measured serum sodium and adjusted sodium levels affect clinical outcomes in severe hyperglycemic patients in the emergency department (ED).
Measuring hypernatremia, correcting hyponatremia, and correcting hypernatremia were all linked to a greater 90-day death rate. Patients with severe measured hyponatremia, on the other hand, did not exhibit an elevated risk of 90-day death in any of the models. This is the only study that we are aware of that examines the link between low adjusted sodium levels for hyperglycemia and clinical outcomes in individuals with severe hyperglycemia. We may ignore the clinical consequences of real hyponatremia if we just utilize measured salt levels to predict clinical outcomes.
How to calculate corrected sodium?
- Choose from the five possibilities in the first line for the patient’s age/sex group: child, adult female, adult male, elderly female, and elderly male.
- Fill in the weight of the patient in the desired unit.
- Enter the sodium level in your blood that you were testing. Type in these numbers if your findings are in mmol/L; in the case of sodium, they are equal to those in mEq/L.
- Select the type of sodium replacement fluid you’ll be using.
- Enter the potassium concentration if the chosen fluid contains it. According to the table above, Lactated Ringer’s has 4 mEq/L (or mmol/L) and Ringer’s acetate has 5 mEq/L (mmol/L).
- In the second to last field, the projected serum sodium change per liter of supply of replacement fluid we express in milliequivalents per liter (mEq/L), which is equivalent to millimoles per liter (mmol/L).
- The determined sodium correction rate is displayed in milliliters per hour (ml/h) in the last field.
What is the corrected sodium formula?
In individuals with hyperglycemia, pre-existing high glucose levels may affect the serum sodium (Na) result. Suppose there is no change in total body water in the context of excessively high blood glucose levels. In that case, the observations of low sodium levels are most likely due to the hyponatremic reaction and should not be mistaken with established hyponatremia.
Before interpreting sodium levels, be sure you do the following:
Sodium Correction (Katz, 1973) = Measured sodium in mEq/L + 0.016 x (Serum glucose in mg/dL – 100)
Sodium Correction (Hillier, 1999) = Measured sodium in mEq/L + 0.024 x (Serum glucose in mg/dL – 100)
And the proposed formula is:
corrected sodium = measured sodium + [1.6 (glucose – 100) / 100].