What is your approach to achieving hypernatremia in a patient on CRRT for whom increasing the rate of a post-filter 3% sodium chloride infusion is insufficient?

Good question. First, we can always increase the rate of the 3% saline more. Eventually, the increased amount of salt will lead to an increase in serum sodium concentration. It has to be a gradual process though to make sure one does not overshoot. Second, if the patient does not require more dialys...

I cannot imagine a reason to “achieve hypernatremia” on a patient on CRRT except perhaps increased intracranial pressure. Regardless with 3% at 512 mmol/l, there is no reason you couldn’t achieve hypernatremia in a pt on Crrt post filter, just increase the rate, and if volume expansion is a concern ...