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Hypernatremia
Brain MRI showing a symmetric central pontine lesion (arrows), sparing the peripheral fibers, with a typical trident shape and areas of restricted diffusion. Suggests osmotic demyelination syndrome. Note the symmetric thalamic lesions (open arrows) in images B and C
BMJ Case Reports 2012, doi: 10.1136/bcr:11.2011.5198
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Hypernatremia
Adrogué-Madias formula. TBW (total body water) = patient body weight (kg) x 0.5 (women/older men) or 0.6 (young men or children) or 0.4 (dehydrated patients). Na = sodium. Sodium concentration of common fluids (per liter): normal saline (0.9%) - 154 mEq/L; lactated Ringer solution - 130 mEq/L; half-normal saline (0.45%) - 77 mEq/L; dextrose 5% in water - 0 mEq/L; enteral water - 0 mEq/L
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Hypernatremia
Possible etiologies of hypernatremia
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Hypernatremia
V = volume needed. Na = sodium. TBW (total body water) = patient body weight (kg) x 0.5 (women/older men) or 0.6 (young men or children) or 0.4 (dehydrated patients). K = potassium. [Na]2 = the desired change in sodium concentration
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Hypernatremia
CT brain showing diffuse sulcal effacement and slight blurring of grey-white differentiation consistent with global cerebral edema. There is no evidence of herniation
Dr Hari Trivedi, Department of Radiology, San Francisco General Hospital, University of California; used with permission
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Hypernatremia
Free water deficit formula. TBW (total body water) = patient body weight (kg) x 0.5 (women/older men) or 0.6 (young men or children) or 0.4 (dehydrated patients). Na = sodium
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Hypernatremia
Possible etiologies of hypernatremia based on urine osmolality
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Hypernatremia
Electrolyte-free water excretion formula. V = urine flow rate. UNa = urine concentration of sodium (mEq/L). UK = urine concentration of potassium (mEq/L). PNa = plasma concentration of sodium (mEq/L)
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