Hypertonic solution

Way to create 3% hypertonic saline:

• 9ml of 23.4% NaCl make up to 100ml NS
  • = 45ml of 23.4% NaCl make up to 500ml NS
  • (Na conc. = 500mEq/L, osmolarity = 1000mOsm/L)
• 3% (wt/v) = 3g NaCl/100ml = 30g/1L
• 1:1 mix of 5.85% with 0.45% → 3.15% HS
• 77ml 5.85% make up to 150ml WFI = 3.003%

NaHCO3 as hypertonic Na solution

• 8.4% bicarb = 2000 mOsm/L
  • = osmolarity of 5.8% NaCl → ~6% saline = double Na load of 3% HS
• In emergency → give 100ml 8.4% bicarb
  • Smaller patient: 50-75ml
  • May be C/I if profound metabolic alkalosis

Also read Safety of hypertonic solution