Intravenous rehydration for hypercalcaemia associated with cancer
Intravenous rehydration is part of the initial management strategy for symptomatic hypercalcaemia (serum total calcium concentration corrected for albumin more than 3.0 mmol/L); a suitable initial regimen is:
sodium chloride 0.9% 200 to 500 mL intravenously, hourly initially, then reassess based on responseStewart, 2005. sodium chloride
The total volume and rate of rehydration required depends on the:
- degree of dehydration
- severity of symptoms
- risk of fluid overload.
Patients with acute severe hypercalcaemia (serum total calcium concentration corrected for albumin more than 3.0 mmol/L) or severe dehydration can require higher rates of fluid administration, but use caution in patients at risk of fluid overload (eg frail and older patients, patients with a history of heart or kidney disease).