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Multiple Electrolyte and Metabolic Emergencies in a Single Patient
Joint Authors
Pham, Phuong-Chi T.
Pham, Phuong-Thu T.
Cadacio, Caprice
Bhasin, Ruchika
Kamarzarian, Anita
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-01-31
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
While some electrolyte disturbances are immediately life-threatening and must be emergently treated, others may be delayed without immediate adverse consequences.
We discuss a patient with alcoholism and diabetes mellitus type 2 who presented with volume depletion and multiple life-threatening electrolyte and metabolic derangements including severe hyponatremia (serum sodium concentration [SNa] 107 mEq/L), hypophosphatemia (“undetectable,” <1.0 mg/dL), and hypokalemia (2.2 mEq/L), moderate diabetic ketoacidosis ([DKA], pH 7.21, serum anion gap [SAG] 37) and hypocalcemia (ionized calcium 4.0 mg/dL), mild hypomagnesemia (1.6 mg/dL), and electrocardiogram with prolonged QTc.
Following two liters of normal saline and associated increase in SNa by 4 mEq/L and serum osmolality by 2.4 mosm/Kg, renal service was consulted.
We were challenged with minimizing the correction of SNa (or effective serum osmolality) to avoid the osmotic demyelinating syndrome while replacing volume, potassium, phosphorus, calcium, and magnesium and concurrently treating DKA.
Our management plan was further complicated by an episode of significant aquaresis.
A stepwise approach was strategized to prioritize and correct all disturbances with considerations that the treatment of one condition could affect or directly worsen another.
The current case demonstrates that a thorough understanding of electrolyte physiology is required in managing complex electrolyte disturbances to avoid disastrous outcomes.
American Psychological Association (APA)
Cadacio, Caprice& Pham, Phuong-Thu T.& Bhasin, Ruchika& Kamarzarian, Anita& Pham, Phuong-Chi T.. 2017. Multiple Electrolyte and Metabolic Emergencies in a Single Patient. Case Reports in Nephrology،Vol. 2017, no. 2017, pp.1-6.
https://search.emarefa.net/detail/BIM-1146985
Modern Language Association (MLA)
Cadacio, Caprice…[et al.]. Multiple Electrolyte and Metabolic Emergencies in a Single Patient. Case Reports in Nephrology No. 2017 (2017), pp.1-6.
https://search.emarefa.net/detail/BIM-1146985
American Medical Association (AMA)
Cadacio, Caprice& Pham, Phuong-Thu T.& Bhasin, Ruchika& Kamarzarian, Anita& Pham, Phuong-Chi T.. Multiple Electrolyte and Metabolic Emergencies in a Single Patient. Case Reports in Nephrology. 2017. Vol. 2017, no. 2017, pp.1-6.
https://search.emarefa.net/detail/BIM-1146985
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1146985