Joining Brian and myself in our virtual studio is Dr Erica Tinson one of our fabulous lecturers in Emergency and Critical Care here at the RVC. Erica has an interest in a variety of topics though we thought that we would discuss the highs and lows of sodium. We focus on the management of the extremes of both, hopefully not something you see commonly, but we hope will help when you do. We hope that you enjoy. 

Some papers of interest:

https://pubmed.ncbi.nlm.nih.gov/31448558/
https://pubmed.ncbi.nlm.nih.gov/28164834/
https://pubmed.ncbi.nlm.nih.gov/28017410/
https://pubmed.ncbi.nlm.nih.gov/10580909/
https://pubmed.ncbi.nlm.nih.gov/8176662/

Some equations of interest:

The Androgué-Madias formula:

Change in serum (Na+) = [infusate (Na+) – serum (Na+)] / total body water +1
Or
Change in serum (Na+) = [infusate (Na+) + infusate (K+) – serum (Na+)] / total body water +1

Free water deficit = {(current [Na+] /normal [Na+])-1} x (0.6 x body weight in kg)

Current Na+ is patients current plasma sodium concentration. Normal Na+ is the patients normal sodium concentration.

Some podcasts of interest

https://emcrit.org/emcrit/hyponatremia/
https://emcrit.org/emcrit/better-management-hyponatremia/

To cite this podcast as: Dom Barfield. RVC Clinical Podcast 126 Deranged sodium with Erica Tinson. Published on Apr 16 2021.

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