Multiorgan donor management. Treatment of severe hypernatremia with intravenous sterile water

We report the initially complicated management of a potential organ donor. Four hours before we removed the organs the potential donor's plasma sodium was 171 mmol/l. As this patient had glucose intolerance and the donation w as urgently required we chose to infuse pyrogen-free sterile water at a rat e of 1.000 ml/hour through a central venous catheter. We reduced the donor's plasma sodium from 171 to 155 mmol/l in 3 hours and 30 minutes without evidence of intravascular hemolysis.