Water and salt. Clinical interpretation of acid-base and electrolyte disorders. Case studies

Chapter 13 Water, electrolytes and acid–base balance Distribution and composition of body water Disorders of sodium concentration Hyponatraemia Hypernatraemia Disorders of potassium concentration Hypokalaemia Hyperkalaemia Disorders of magnesium concentration Hypomagnesaemia Hypermagnesaemia Disorders of phosphate concentration Hypophosphataemia Hyperphosphataemia Acid–base disorders ...

Fluids and electrolytes are basic components of the human body and essential for ... Correction of electrolyte or acid-base disorders ... In a meta-analysis, use of hypertonic saline showed no differences in clinical outcomes ... In some ... 26 Jan 2018 ... Acid-base and electrolyte alterations are common in patients with chronic ... herald hyperkalemia and alterations in sodium (Na+) and water balance. ... We discuss several representative cases encountered in practice, ... ...

Approach to Fluid and Electrolyte Disorders and Acid-Base Problems. Author links open overlay panel Biff F ... Extrarenal losses of salt and water from the gastrointestinal tract or from profuse sweating or renal losses because of osmotic diuresis are the ... Interpret the acid-base disorders in the context of the clinical presentation.

5 • Extrarenal losses • Vomiting, diarrhea, 3rd spacing, burns, pancreatitis, trauma • Positive orthostatics, dry mucous membranes, diminished skin turgor • Una <20 • Increase in ADH • Helps to preserve BP • Activation of V2 receptors, free water reabsorption • Treatment • Isotonic saline – rapid reduction in ADH brisk water diuresis Hypovolemic Hyponatremia

The commonest clinical electrolyte and acid ebase derangements (see Clinical approach to electrolyte abnormalities on pages 381e 388 of this issue for detailed guidance on clinical management) Hypo- and hypernatraemia Both are primarily problems of water, rather than sodium bal-ance. Plasma sodium concentration (P Na) represents the ratio of