China
Africa
Explore chapters and articles related to this topic
Pyloromyotomy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
It may take as long as 48–72 hours for rehydration to be complete and for the infant to be ready for surgery. The goal is to correct the serum electrolytes to nearly normal. Accordingly, the serum potassium should be at least 3–4.5 mEq/L, the serum CO2 should be <27–30 mEq/L, and the serum sodium should be >130 mEq/L before surgery is considered. The serum chloride will usually correct itself to >100 mEq/L with the above measures.
Gastrointestinal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
6.5. A 5-week-old infant presents with projectile vomiting of increasing severity for 10 days. He appears moderately dehydrated. The probable laboratory findings would beelevated blood pH.increased serum chloride.increased serum bicarbonate level.decreased urinary potassium level.low serum potassium level.
Principles of Clinical Pathology
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Niraj K. Tripathi, Jacqueline M. Tarrant
Reference intervals for serum electrolyte concentrations in clinical settings are relatively broad compared with the range of concentrations usually observed in controlled nonclinical studies, and very small but statistically significant differences between the control and treated groups are a relatively frequent occurrence. Some of these small differences (e.g., 1 to 3 mmol/L for serum sodium or chloride concentration) are incidental, but others probably reflect subtle homeostatic effects associated with minor differences in food intake or fluid balance that are not indicative of significant toxicity. Effects on serum sodium and chloride concentrations usually parallel each other, and concurrent decreases are most commonly observed with gastrointestinal losses (i.e., vomiting or diarrhea) and renal losses (i.e., tubular dysfunction due to toxicity or a diuretic effect). Vomiting may decrease serum chloride concentration to a greater degree because of the loss of hydrochloric acid from the stomach. Slightly increased serum chloride concentration is observed on rare occasion as a result of secretory diarrhea and metabolic acidosis from loss of bicarbonate; decreased availability of bicarbonate causes increased renal tubular reabsorption of chloride.
Associations between serum electrolyte and short-term outcomes in patients with acute decompensated heart failure
Published in Annals of Medicine, 2023
Kai Zhao, Qun Zheng, Jiang Zhou, Qi Zhang, Xiaoli Gao, Yinghua Liu, Senlin Li, Weichao Shan, Li Liu, Nan Guo, Hongsen Tian, Qingmin Wei, Xitian Hu, Yingkai Cui, Xue Geng, Qian Wang, Wei Cui
A total of 5145 participants (58.3% men; median age 69 y) comprised the potassium-related study population, with 631, 1784, 1726, 720 and 284 patients classified as internal 1 (K: <3.50 mmol/L), internal 2 (K: 3.50–4.00 mmol/L), interval 3 (K: 4.01–4.50 mmol/L), interval 4 (K: 4.51–5.00 mmol/L) and interval 5 (K: >5.00 mmol/L), respectively. Meanwhile, the sodium-related study population (58.3% men; median age 69 y) included 5135 participants categorized into five groups according to their serum sodium levels. Furthermore, 4966 patients from the chloride-related study population (58.0% men; median age 69 y) were divided into four different groups based on their serum chloride concentrations. Finally, differing from the above, the STC-related study population (58.7% men; median age 68 y) was composed of 4143 patients stratified into three groups on the basis of their STC levels.
Thiocyanate toxicity: a teaching case
Published in Clinical Toxicology, 2022
C. James Watson, Daniel L. Overbeek, Gabriella Allegri-Machado, Mark D. Kellogg, Al Patterson, J. Brian McAlvin, Michele M. Burns
A 17-year-old female (65.5 kg) with a history of depression presented via ambulance to a community emergency department (ED) one hour after ingesting a “half shot glass” of powdered potassium thiocyanate mixed with non-alcoholic ginger ale. She purchased the thiocyanate bottle (Figure 1) online believing it was cyanide, and ingested it with suicidal intent. At the community ED, she was asymptomatic with normal vital signs, normal mental status, and a normal physical exam. Serum studies reported hyperchloremia (132 mmol/L), normal bicarbonate (28 mmol/L), an anion gap of −20, and an elevated salicylate concentration (115 mg/dL). The patient denied co-ingestions. No symptoms nor signs of salicylism were observed. A sodium bicarbonate infusion was initiated given the salicylate concentration and she was transferred to a tertiary pediatric center. At the tertiary ED, she developed dizziness and blurry vision. Repeat testing showed a whole blood (WB) chloride of 145 mmol/L, a serum chloride of 110 mmol/L, and undetectable salicylates. Her ionized calcium (iCa) was low at 0.9 mmol/L. Bicarbonate therapy was stopped and the patient was admitted to the intensive care unit (ICU). Table 1 shows relevant laboratory values.
Approach to the patient presenting with metabolic acidosis
Published in Acta Clinica Belgica, 2019
Jill Vanmassenhove, Norbert Lameire
The third step in the approach is to differentiate between a high AG metabolic acidosis and a normal AG or hyperchloremic metabolic acidosis by calculating the plasma AG (see equation) [12]. Historically, the normal range for the plasma AG was 7–13 mEq/L. However, newer autoanalyzers measure a higher serum chloride concentration, resulting in a lower normal range of 3 to 9 mmol/L. As a result, it is important to determine the normal range for electrolytes and the AG in each laboratory for accurate interpretation of its value (we refer to the article by Delanghe in this issue). It should be remembered that falsely elevated chloride values can be present in bromide intoxications.