Isotonic Versus Hypotonic Fluids for Hypernatremia?

Most of your cases are going to be chronic hypernatremia and for this a reasonable goal that's extrapolated from pediatric data is roughly 10 to 12 milliquivalence per day. In terms of fluids I recommend what I always tell teams is if it's relevant to the case separate out in your mind hypovolemia meaning water and sodium losses from dehydration. So again here I'll often get questions about if we can just do hypotonic fluids like half NS to address both. My goal rate is determined by calculating the free water deficit to get down to my goal sodium for the day plus my ongoing free water losses.