Validity of the Adrogué-Madias Formula for the Management of Acute Dysnatremias in Critically Ill Children: A Prospective Multicenter Analysis

Pediatr Emerg Care. 2023 Sep 1;39(9):707-714. doi: 10.1097/PEC.0000000000002949. Epub 2023 May 17.

Abstract

Objective: Current conventional formulas do not predict the expected changes in serum sodium after administration of various fluids to correct serum sodium abnormalities. The Adrogué-Madias formula is currently the preferred and widely used fluid prescription for adult patients with dysnatremias, but its therapeutic efficacy has not been validated in pediatric patients.

Methods: In this prospective study, we used the Adrogué-Madias formula for calculating the appropriate rate of various fluids administration to correct serum sodium abnormalities in 7 critically ill children with acute dysnatremias.

Results: After administration of various intravenous fluids using the Adrogué-Madias formula, the anticipated as well as the achieved sodium concentrations were almost similar.

Conclusions: This study demonstrates that the use of the Adrogué-Madias quantitative formula allows to calculate the appropriate rate of administration of various fluids. The calculated fluid administration resulted in the subsequent actual laboratory values and clinical changes.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Behavior Therapy
  • Child
  • Critical Illness / therapy
  • Humans
  • Hyponatremia*
  • Prospective Studies
  • Sodium

Substances

  • Sodium