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Central Diabetes Insipidus — Free Water Replacement — Clinical Pathway: PICU

Central Diabetes Insipidus (DI)/Arginine Vasopressin Deficiency (AVP-D) Clinical Pathway – PICU

Free Water Replacement

  • Free water replacement may be needed to correct hypernatremia
  • Replace fluid deficit using the following recommendations:
    • Replacement is typically given over 24 hrs but will depend on the degree of deficit and hypernatremia, as well as duration of hypernatremia
    • If Na remains above goal after free water replacement, reassess
Typical Fluid Choices
  • D5 0.45 NaCl
  • D5 0.2 NaCl
  • D5 LR
  • If allowed to take PO, NG or GT, provide enteral water
Calculation for Fluid Replacement Volume 0.6 x weight (kg) x (1-target Na/current Na)
Max Na Change 10-12 mEq/L/24 hrs

 

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