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Severely symptomatic 2 IV bolus 150 ml 3% hypertonic over 20 min, check serum sodium Repeat IV bolus 150 ml 3% hypertonic over 20 min, check serum sodium Provide up to two additional 150 mL boluses, spaced 20 minutes apart, until a 5 mmol/L increase in sodium concentration is reached If symptoms improve after a 5 mmol/L increase is achieved, stop infusion and attempt to treat underlying cause Monitor sodium concentration every 6 hours If symptoms do not improve continue IV 3% hypertonic saline at a rate leading to an increase of 1 mmol/L/hr

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Thus, if you would like to get an effective result of the therapy and decrease the risk of possible complications, it is better to follow these simple recommendations