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Normal volume hypernatremia can be due to fever, extreme thirst, prolonged increased breath rate, diabetes insipidus, and from lithium among other causes. [1] High volume hypernatremia can be due to hyperaldosteronism, excessive administration of intravenous normal saline or sodium bicarbonate, or rarely from eating too much salt.
Saline solution for irrigation. Normal saline (NSS, NS or N/S) is the commonly used phrase for a solution of 0.90% w/v of NaCl, 308 mOsm/L or 9.0 g per liter. Less commonly, this solution is referred to as physiological saline or isotonic saline (because it is approximately isotonic to blood serum, which makes it a physiologically normal solution).
The treatment and recovery phases of diabetic ketoacidosis; Volume resuscitation with 0.9% normal saline provides a chloride load, so that infusing more than 3–4L can cause acidosis; Hyperalimentation (i.e., total parenteral nutrition)
It is crucial to first assess the stability of the patient. If there are any signs of shock such as tachycardia or hypotension, these must be treated immediately with IV saline infusion. [3] [27] Once the patient is stable, it is important to identify the underlying cause of hypernatremia as that may affect the treatment plan.
Hyperchloremia is an electrolyte disturbance in which there is an elevated level of chloride ions in the blood. [1] The normal serum range for chloride is 96 to 106 mEq/L, [2] therefore chloride levels at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride concentration. [3]
Salt poisoning is an intoxication resulting from the excessive intake of sodium (usually as sodium chloride) either in solid form or in solution (saline water, including brine, brackish water, or seawater). Salt poisoning sufficient to produce severe symptoms is rare, and lethal salt poisoning is possible but even rarer.
This keeps serum sodium concentration – a proxy for solute concentration – at normal levels, prevents hypernatremia and turns off the osmoreceptors. [7] Specifically, when the serum sodium rises above 142 mEq/L, ADH secretion is maximal (and thirst is stimulated as well); when it is below 135 mEq/L, there is no secretion. [8]
Intravenous sodium bicarbonate is indicated in the treatment of metabolic acidosis, such as can occur in severe kidney disease, diabetic ketoacidosis [citation needed], circulatory insufficiency, extracorporeal circulation of blood, in hemolysis requiring alkalinization of the urine to avoid nephrotoxicity of blood pigments, and certain drug intoxications, such as by barbiturate overdose ...