pediatrics
Neonatal Hyponatremia
Treatment of Neonatal Hyponatremia
IV 5%dextrose/0.45% to 0.9% saline solution Rarely IV hypertonic (3%) saline solution Treatment of neonatal hyponatremia is with 5% D/0.45% to 0.9% saline solution IV in volumes equal to the calculated deficit, given over as many days as it takes to correct the sodium concentration by no more than 10 to 12 mEq/L/day (10 to 12 mmol/L/day) to avoid rapid fluid shifts in the brain. Neonates with hypovolemic hyponatremia need volume expansion, using a solution containing salt to correct the sodium deficit (10 to 12 mEq/kg [10 to 12 mmol/kg] of body weight or even 15 mEq/kg [15 mmol/kg] in young infants with severe hyponatremia) and include sodium maintenance needs (3 mEq/kg/day [3 mmol/kg/day] in 5%dextrosesolution). Neonates with symptomatic hyponatremia (eg, lethargy, confusion) require emergency treatment with 3% saline solution IV to prevent seizure or coma. 