Undercorrection of hypernatremia is frequent and associated with mortality

BMC Nephrology

Table 2 Initial fluid replacement strategy on arrival at emergency department

Treatments	n = 85
Perfused solute
Hypotonic solute	64%
Isotonic solute	28%
0.9% sodium chloride	67%
Ringer’s lactate*	21%
Hydroxyethyl starch 130/0.4**	12%
No perfusion	1%
Unknown	7%
Perfused solute according to mean blood pressure
MBP <70 mmHg	24%
Hypotonic solute	45%
Isotonic solute	55%
MBP ≥ 70 mmHg	69%
Hypotonic solute	71%
Isotonic solute	20%
No perfusion	2%
Unknown	7%
Unknown MBP	7%
Other
No prescribed perfusion rate	74%
Perfusion not reported in file by the nurse	6%

*Ringer’s lactate contains sodium lactate 3.2 g/L and sodium chloride 6 g/L.
**Hydroxyethyl starch 130/0.4 contains hydroxyethyl starch 130 60 g/L and sodium chloride 9 g/L.
As described in the Methods, hypotension requiring isotonic solute perfusion was defined as a mean blood pressure (MBP) <70 mmHg. Thus, intravenous perfusion was inappropriate for almost half of patients with MBP <70 mmHG who received hypotonic solutes, and for nearly a quarter when MBP ≥70 mmHg who received isotonic solutes or were not perfused.

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