From the Research
In hyponatremia management with a Lasix (furosemide) drip, the urine output goal typically ranges from 100-200 mL/hour or approximately 2-3 mL/kg/hour. This rate allows for controlled diuresis while monitoring serum sodium levels. When initiating a Lasix drip, start at 5-10 mg/hour and titrate based on the patient's response, with close monitoring of electrolytes every 2-4 hours, as suggested by 1. The goal is to achieve a gradual correction of serum sodium by no more than 8-10 mEq/L in 24 hours to avoid osmotic demyelination syndrome, which is a rare but severe neurological condition that can result in parkinsonism, quadriparesis, or even death, as noted in 1. Some key points to consider in hyponatremia management include:
- Fluid restriction is often implemented concurrently, and replacement fluids may be needed depending on the patient's volume status.
- Regular assessment of vital signs, mental status, and fluid balance is essential.
- The approach works because Lasix inhibits sodium reabsorption in the loop of Henle, promoting free water excretion and helping to correct the dilutional hyponatremia while maintaining control over the rate of sodium correction. It's also important to consider the underlying cause of hyponatremia and manage it accordingly, as hyponatremia can be caused by various conditions, including heart failure, syndrome of inappropriate antidiuresis, and hypovolemia, as discussed in 2, 3, and 4. However, the most recent and highest quality study, 1, provides the most relevant guidance for managing hyponatremia with a Lasix drip.