In a patient with severe hyponatremia and acute kidney injury in the setting of hypovolemic shock, would fluid resuscitation take precedence over the rate at which sodium is corrected?
Answer from: at Academic Institution
Normal saline, or a balanced fluid, e.g., Lactated Ringers or Plasmalye, if you are believers in balanced fluids.
Shock trumps ANY concerns over rate of Na rise.
Also if someone is in shock they are not going to have a water diuresis from volume.
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Answer from: at Academic Institution
I believe it is possible to achieve both aims. Even though normal saline is more efficient in increasing extracellular volume, administration of D5W will lead to some increase in the extracellular volume not to mention half normal saline. Through careful combination of the fluid administered and fre...