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Electrolyte disturbances

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Electrolyte disturbances Moderator Dr Sumesh Rao Presenter Dr Nikhil MP
Disorders of sodium balance
Normal plasma sodium is 135 to 145 meq/l
Hyponatremia
Plasma sodium <135 meq/l
Types ,[object Object],[object Object],[object Object]
Hypoosmolal hyponatremia
Types ,[object Object],[object Object],[object Object]
Hyopovolemic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Euvolemic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hypervolemic ,[object Object],[object Object],[object Object]
Pseudohyponatremia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical features
[object Object]
Clinical features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
diagnosis
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
cont……. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
treatment
Goals of therapy ,[object Object],[object Object]
principles ,[object Object],[object Object],[object Object],[object Object]
When to treat....? ,[object Object],[object Object]
Cont…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
To calculate Na deficit ,[object Object],[object Object],[object Object],[object Object]
Change in plasma sodium ,[object Object],[object Object]
Case history ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rapid correction can lead to… ,[object Object],[object Object],[object Object],[object Object],[object Object]
Anaesthetic implications ,[object Object],[object Object],[object Object],[object Object]
Hypernatremia
Plasma sodium>145meq/l
causes
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types ,[object Object],[object Object],[object Object]
Hypernatremia with low body sodium content ,[object Object],[object Object],[object Object],[object Object]
Hypernatremia with normal total body sodium content ,[object Object],[object Object],[object Object],[object Object]
Hypernatremia and increased total body sodium content ,[object Object],[object Object]
Clinical features
[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
diagnosis
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
treatment
Goals of therapy ,[object Object],[object Object]
principles ,[object Object],[object Object],[object Object]
To calculate water deficit ,[object Object],[object Object]
Rapid correction can lead to… ,[object Object]
Anaesthetic implications ,[object Object],[object Object],[object Object],[object Object]
Disorders of potassium balance
Normal plasma potassium is 3.5 to 5 meq/l
Hypokalemia
Plasma potassium < 3.5 meq/l
causes
[object Object],[object Object],[object Object]
Redistribution into cells ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Increased loss ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Decreased intake ,[object Object],[object Object]
Clinical features
[object Object],[object Object],[object Object],[object Object]
Neuromuscular
Neuromuscular ,[object Object],[object Object],[object Object],[object Object],[object Object]
cardiovascular ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ECG Changes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
diagnosis
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
treatment
Therapeutic goals ,[object Object],[object Object],[object Object]
principles ,[object Object],[object Object],[object Object]
treatment
When to treat…..? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Oral potassium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Iv potassium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cont….. ,[object Object],[object Object],[object Object],[object Object]
Cont…. ,[object Object],[object Object]
Anaesthetic implications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hyperkalemia
Plasma potassium >5 meq/l
causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cont… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical features
skeletal
skeletal ,[object Object],[object Object]
[object Object]
cardiac ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
diagnosis ,[object Object],[object Object],[object Object],[object Object]
Cont…… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
treatment
principles ,[object Object],[object Object],[object Object],[object Object]
Calcium gluconate ,[object Object],[object Object],[object Object],[object Object],[object Object]
Insulin & glucose ,[object Object],[object Object],[object Object]
cont….. ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cont… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Anaesthetic implications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Disorders of calcium balance
[object Object],[object Object]
hypocalcemia
Plasma calcium <8.5 mg dl
causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
ECG ,[object Object]
treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anaesthetic implicatons ,[object Object],[object Object],[object Object],[object Object],[object Object]
hypercalcemia
[object Object]
causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ECG changes ,[object Object],[object Object],[object Object]
 
treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anaesthetic implications ,[object Object],[object Object],[object Object],[object Object],[object Object]
Disorders of magnesium balance
hypomangnesemia
Plasma mg+ <1.7 meq/l
causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
clinical features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
treatment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Things to be monitored ,[object Object],[object Object],[object Object]
 
Anaesthetic implications ,[object Object],[object Object]
Hypermagnesemia
Plasma mg > 2.5 meq/l
causes ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical features ,[object Object],[object Object],[object Object],[object Object]
treatment ,[object Object],[object Object],[object Object]
Anaesthetic considerations ,[object Object],[object Object],[object Object]
Referances ,[object Object],[object Object],[object Object],[object Object]
thank you

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Electrolyte disturbances