DDAVP Clamp Protocol in Hyponatremia
 • Stop any maintenance fluids.
 • Start DDAVP 2 mcg IV q8h
 • Start 3% NaCl (1-1.5 ml/kg over 6 hours)
 • Fluid restrict patient to 1.2 liters per day
 • Monitor sodium every 2 hours initially. Once the sodium is rising predictably, decrease frequency to every 4-6 hours.
 • Adjust 3% NaCl infusion rate to achieve correction of less than 8 mmol/L per day. Try to avoid adjusting the rate more than every 6 hours. Look at the sodium trend rather than the latest value.
 • Continue 3% and DDAVP until the sodium is 125-130

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