| Guideline Organization/Societies | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Criteria/categories | NIV [16] | NHS [17] | GAIN [22] | AEEH [23] | EHN [25] | ERBP/ESE/ESICM [20] | UF [18] | HEP [19] | RCHM [21] | EAH-ICD [24] |
Symptoms | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â |
Acute Onset (<48 h) | NaCl >1% Infusion speed may be guided by Adrogué-Madias | NaCl 3% | NaCl 2.7% 200 mL over 30 min |  | NaCl 3% 100 mL/10 min up to 3× or infused at 0.5–2 mL/kg/h | NaCl 3% 150 mL/20 min up to 4× | NaCl >1% | NaCl 3% 100 mL/10 min up to 3× or infused at 0.5–2 mL/kg/h | NaCl 3% 4 mL/kg over 30 min | NaCl 3% 100 mL bolus |
Hypovolemia | Â | Â | Â | Â | Â | Â | Â | NaCl 0.9% until blood pressure restored | Â | Â |
Euvolemia | Â | Â | Fluid restriction | Â | Â | Â | Â | Â | Â | No hypotonic fluids |
 |  |  | Stop offending drugs |  |  |  |  |  |  |  |
 |  |  | Stop hypotonic fluids |  |  |  |  |  |  |  |
Hypervolemia | Â | Â | Furosemide | Â | Â | Â | Â | Furosemide | Â | Â |
Chronic onset (>48 h) | NaCl >1% Infusion speed calculation may be guided by Adrogué-Madias | NaCl 3% | Only if severe symptoms NaCl 2.7% 200 mL over 30 min infusion speed by may be guided Adrogué-Madias |  | NaCl 3% 100 mL/10 min up to 3× or infused at 0.5–2 mL/kg/h | NaCl 3% 150 mL/20 min up to 4× | NaCl >1% | NaCl 3% 100 mL/10 min up to 3× or infused at 0.5-2 mL/kg/h |  |  |
Hypovolemia |  |  | NaCl 0.9% 1 L over 2–4 h infusion speed may be guided by Adrogué-Madias |  |  |  |  | NaCl 0.9% until blood pressure restored |  |  |
Euvolemia | Â | Â | Fluid restriction | Â | Â | Â | Â | Â | Â | Â |
 |  |  | Stop offending medications |  |  |  |  |  |  |  |
 |  |  | Stop hypotonic fluids |  |  |  |  |  |  |  |
Hypervolemia | Â | Â | Fluid restriction | Â | Â | Â | Â | Furosemide | Â | Â |
 |  |  | Salt restriction |  |  |  |  |  |  |  |
No symptoms | Â | Â | Â | Â | Â | Â | Â | Â | Â | |
Acute onset (<48 h) | NaCl >1% Infusion speed by Adrogué-Madias |  | Treat underlying condition |  |  | Stop offending fluids and medications, treat underlying condition NaCl 3% 150 mL/20 min |  | Treat underlying condition |  | |
Chronic onset (>48Â h) | Treat underlying condition | Â | Treat underlying condition | Â | Â | Stop non-essential fluids Stop offending medications Treat underlying condition | Â | Treat underlying condition | Â | Â |
Hypovolemia | NaCl 0.9% | NaCl 0.9% until blood pressure restored | NaCl 0.9% infusion speed may be guided by Adrogué-Madias |  |  | NaCl 0.9% or balanced crystalloid 0.5–1 mL/kg/h | NaCl 0.9% | NaCl 0.9% until blood pressure restored | Nasogastric rehydration |  |
 | NaCl tablets |  |  |  |  |  |  | No VPA | NaCl 0.9% |  |
Euvolemia | Fluid restriction, dose dependent on serum and urinary electrolytes | Fluid restriction, 500–1,000 mL/d | Fluid restriction |  | Fluid restriction <500–1,000 mL/d | Fluid restriction | Fluid restriction | Fluid restriction 500 mL below average daily urine output | Fluid restriction, no hypotonic fluids |  |
 |  | No salt restriction | Salt restriction |  | Salt 5–8 g/d |  |  | No salt restriction |  |  |
 | Loop diuretics |  |  |  | Furosemide 20–60 mg/d + oral NaCl | Loop diuretics, low dose + oral NaCl | Diuretics |  |  |  |
 | Demeclocycline | Demeclocycline |  |  |  | No demeclocycline | Demeclocycline | Demeclocycline, 600–1,200 mg/d |  |  |
 | Urea |  |  |  | Urea 30 g/d | Urea, 0.25–0.5 g/kg/d | Urea | Urea, 15–60 g/d |  |  |
 | Vasopressin receptor antagonist | Vasopressin receptor antagonist |  | Tolvaptan 15–60 mg/d | No vasopressin receptor antagonists |  |  |  |  | |
Hypervolemia | Â | Treat underlying condition | Â | Â | Â | Â | Â | Â | Â | Â |
 | Fluid restriction, dose dependent on serum and urinary electrolytes | Fluid restriction | Fluid restriction | Fluid restriction <1,000 mL/d |  | Fluid restriction |  | Fluid restriction, <insensible losses + urine output | Fluid restriction |  |
 | Loop diuretics | Salt restriction | Salt restriction | No NaCl >0.9% |  |  |  | Salt restriction |  |  |
 |  | Demeclocycline |  | Stop diuretics |  | No demeclocycline |  | Possibly vasopressin receptor antagonist |  |  |
 |  | Vasopressin receptor antagonist |  |  |  | No vasopressin receptor antagonist |  |  |  |  |