Table 2.

Management of DI and hyponatraemia in the COVID-19 patient in intensive care setting.

	Clinical scenario	Action
Diabetes insipidus	Routine care	As per published guidelines Careful attention to desmopressin dose and fluids
	Hypernatraemic dehydration	Hypotonic IV fluids Urine losses + insensible losses = agreed target to reverse hypernatraemia Careful monitoring for ARDS and pulmonary oedema Prophylactic anticoagulation
Hyponatraemia	Routine care	As per published guidelines
	Hypovolaemic hyponatraemia	IV 0.9% sodium chloride solution Rate individualized to patient and agreed with intensivists Careful monitoring for ARDS and pulmonary oedema
	Acute severe hyponatraemia with CNS irritation	Aim to elevate pNa by 8–12 mmol/l/24 h Continuous IV infusion of 3% saline recommended to control fluid load or careful IV bolus 3% saline Monitor pNa every 2–4 h

AKI, acute kidney injury; pNa, plasma sodium concentration.