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💧 Adrogué–Madias Fluid Formula

UseEnter current sodium, weight, sex, age category, and infusate; the tool returns the predicted ΔNa per liter a…

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SourceAdrogué HJ, Madias NE. Hyponatremia. N Engl J Med. 2000. doi:10.1056/NEJM200005253422107

Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders

This-shift next steps

After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.

Score + version; reference only — not a substitute for care · no HIS write

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Methodology · worked example, guidelines & full notes
Clinical takeaway

Limit chronic hyponatremia correction to ≤8–10 mmol/L/24h to avoid osmotic demyelination, and chronic hypernatremia to ≤10–12 mmol/L/24h to avoid cerebral edema (original synthesis · not guideline verbatim).

When to use

Enter current sodium, weight, sex, age category, and infusate; the tool returns the predicted ΔNa per liter and estimated total body water.

How it works

ΔNa per liter = (infusate Na − serum Na) / (total body water + 1). TBW = weight × factor (0.6 male, 0.5 female; 0.5/0.45 if elderly).

Key points

  • Limit chronic hyponatremia correction to ≤8–10 mmol/L/24h to avoid osmotic demyelination, and chronic hypernatremia to ≤10–12 mmol/L/24h to avoid cerebral edema (original synthesis · not guideline verbatim).
  • The formula ignores ongoing urinary and insensible losses, so it is a starting estimate that requires frequent re-measurement.
  • Hypertonic 3% saline (Na 513) raises sodium fastest; 5% dextrose (Na 0) lowers it and is used for hypernatremia.

References

Worked calculation

The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.

Current serum sodium120 mmol/L
Weight70 kg
SexMale
ElderlyYes
Infusate typeLactated Ringer's (Na≈130)

→Predicted ΔNa per liter0.3mmol/L

  • Total body water (est.):35 L
  • Direction:Raises serum sodium
Current serum sodium120 mmol/L
Weight70 kg
SexMale
ElderlyYes
Infusate type3% hypertonic saline (Na 513)

→Predicted ΔNa per liter10.9mmol/L

  • Total body water (est.):35 L
  • Direction:Raises serum sodium
Verification & sources · governance
FAQ

Frequently asked questions

What are the limits and cautions when using Adrogué–Madias Fluid Formula?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
Does Adrogué–Madias Fluid Formula upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is Adrogué–Madias Fluid Formula calculated in practice? Can you show a worked example?
Inputs: Current serum sodium 120 mmol/L, Weight 70 kg, Sex Male, Elderly Yes, Infusate type Lactated Ringer's (Na≈130) → Result: Predicted ΔNa per liter 0.3 mmol/L(Total body water (est.): 35 L, Direction: Raises serum sodium) Inputs: Current serum sodium 120 mmol/L, Weight 70 kg, Sex Male, Elderly Yes, Infusate type 3% hypertonic saline (Na 513) → Result: Predicted ΔNa per liter 10.9 mmol/L(Total body water (est.): 35 L, Direction: Raises serum sodium)
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