electrolytes

Patients with severe hyponatremia ( < 120 mEq/L) can present with altered mentation, seizures, lethargy, and even coma. After identifying the likely cause(s), treatment is centered around a combination of sodium replacement (usually with...

Sodium is the primary cation (positive-charged ion) in the extracellular space. Therefore, dilutional hyponatremia can occur if free water is added to the extracellular space from fluid shifts and infusions. Let's look at this basic...

Sodium (Na) fluctuations portend increased in-hospital death for ICU patients, and when working them up, it's essential to determine if these disorders are acute or chronic (> 48 hours or unknown duration). For hypernatremia...

Calcium is traditionally reported as a total serum concentration (i.e., complete metabolic profiles) and ionized calcium concentration (i.e., blood gases). To interpret these labs, one must understand what they represent. Under normal physiologic conditions,...

As an intensivist and anesthesiologist, I spend considerable time pondering the physiology and evidence for practices and questioning dogma rampant in the ICU/OR settings. I've heard one recurrent theme: the fear of using Lactated...

Magnesium is an important intracellular electrolyte that regulates neuronal conduction, vascular tone, myocardial excitation, and muscular contraction. Patients often lose magnesium through significant NG tube drainage, diarrhea, and diuresis. Many of them also come...

Calcium chloride (CaCl2) is an ionic form of intravenous calcium repletion with roughly three times more bioavailable calcium than its organic counterpart - calcium gluconate. The teaching that one needs a functional liver to metabolize...

Potassium chloride (KCl) is a form of intravenous electrolyte repletion in hypokalemia - the most common electrolyte disorder in hospitalized patients often caused by diarrhea, vomiting, loop/thiazide diuretics, steroids, and poor intake among many...