The acute hyponatremia was initially attributed to the continuous infusion of 5% dextrose
half-normal saline in association with presumed lung cancer induced SIADH.
Normal saline was used most often (80% of cases), followed by
half-normal saline (12%), and the median administered volume was 1,000 mL.
Prehydration with intravenous
half-normal saline was compared with prehydration with normal saline in a large, randomized trial, and the results favored normal saline for CIN prophylaxis.
With dextrose on board, a switch to
half-normal saline is warranted.