How to correct potassium as per pH i.e. in acidosis and alkalosis in ICU; explained by Dr. P.K.Jain

No video

How to correct potassium as per pH i.e. in acidosis and alkalosis in ICU; explained by Dr. P.K.Jain

Рет қаралды 15,893

Жыл бұрын

How to correct potassium as per pH in ABG i.e. in acidosis and alkalosis in ICU; explained by Dr. P.K.Jain
ESBICM official links:
This channel: ‪@TheICUChannel‬
ICU forums for queries and discussions: icu.in/forums/...
Telegram group for Dr Ankur’s Voice messages and Tips: t.me/theicucha...
Instagram for Behind the scenes and light moments of ICU: / theicuchannel
ESBICM Membership form (Free for ICU health care professionals):
forms.gle/ovQD...
The above video is trying to explain or answer the following queries:
How to correct potassium as per pH in ABG
How to correct potassium in acidosis and alkalosis
Correction factor for potassium in acidosis and alkalosis
Correction factor for potassium as per pH change in ABG
Regards:
ESBICM Team, esbicm.com | icu.in
(Educational Society of Bedside Intensive Care Medicine)
Do read disclaimer:
esbicm.com/dis...
About ESBICM:
Educational Society of Bedside Intensive Care Medicine (ESBICM) is an organisation with the mission to change the way intensive care is delivered in the world today using this platform for providing FREE Bedside Intensive Care Education to every healthcare professional involved in care of critically ill patients.

Пікірлер: 111

@vijayalakshmicmsunderaj595 Жыл бұрын

Pearls like this are priceless. It drums it into your head. A Red flag is raised before you act. The years of immersion in the field. Thank you.

@sultanzaffar1017 Ай бұрын

Great I really enjoyed your short lecture

@swaroopak8368 12 күн бұрын

Very useful sir. Thank you so much for giving us such pearls

@RaviKumar-ml8ob 29 күн бұрын

Thank you so much sir, excellent sir

@drMahroshFalak Жыл бұрын

Awesome Sir ❤🇵🇰 Life savings tips with examples are best of all so far. I would like to suggest you to continue such shorts 5 to 10 min clips of common critical cases encountered in ICU are mistakes that must be highlighted in managing them.

@chairman-ccef7876 Жыл бұрын

Thank you

@Archer396 Жыл бұрын

I panicked when a pt was in hyperkalemia post blood transfusion, my consultant had my back since I was new in ICU! Thank God 🙏

@chairman-ccef7876 Жыл бұрын

It is a frightening situation as the hyperkalemia is real and due to RBC breakdown releasing the large intracellular potassium.

@Archer396 Жыл бұрын

@@chairman-ccef7876 yes yes

@drnaseemuddinkalhoro3542 5 ай бұрын

This is best one. Currently I am working in ICU in KSA. Your channel is a great help for me. Thank you so much sir

@shubhamtripathi405 Ай бұрын

So good sir ....thank you so much ....

@mukundrajta2576 Жыл бұрын

We need more videos and learning like this sir ..... looking forward Thank you sir

@chandrakantchandak Жыл бұрын

We are all privileged to be bestowed with these extremely helpful lessons sir. They are of immense value.. please do continue them. Thank you!❤

@chairman-ccef7876 Жыл бұрын

😊 Thank you

@meeradewangan5862 Жыл бұрын

Thankyou sir 🙏 I am nurse this information is give us lot of knowledge 🙏 sir pls also include videos in mix Hindi language, for precise and clear understanding

@faizdr1723 3 ай бұрын

Well done sir May Allah grant you long healthy life

@haha..551 10 ай бұрын

Excellent information 👍

@chamariliyanage9626 Жыл бұрын

It really worth,Thank you so much sir.

@saminkazi4999 Жыл бұрын

Wonderful explanation

@TheICUChannel Жыл бұрын

Glad you liked it

@tusharchopawar8255 11 ай бұрын

Such a minute details but so crucial, very commonly ignored Thank u so much👍👍👍

@widaltyph491 Жыл бұрын

Thank you Sir! Kindly make a snippet of IV magnesium correction. Thank you!

@chairman-ccef7876 Жыл бұрын

Wonderful recommendation. Will do that soon.😊

@sanjoyghosh2183 Жыл бұрын

Priceless piece of information Sir

@tradingchannell Жыл бұрын

Amazing once again❤. Though there alot of blunders is happening when we look around in our area's (in ICU). it's shame when u do something to a patient without having a knowledge about it, I wish to tagg my colleagues those who do arguments on something which they don't know, even though I have recommended this channel to them but they don't have time for it to learn and accept what is right. To be honest i learned alot from this channel andhv been watching since beginning,

@Dr.Amritkumaryadav Жыл бұрын

Very valuable information indeed

@shubhamsingh-xk4br 5 ай бұрын

Thank you so much sir

@TheICUChannel 5 ай бұрын

Most welcome

@hishighnessab5540 7 ай бұрын

Looking forward for more from you sir. It was very precise and very informative.

@TheICUChannel 7 ай бұрын

Glad you liked it

@nandan0000s 11 ай бұрын

Mind blowing concept...... Thank you for your innovative steps We are with you 🙏🏼

@nandan0000s 11 ай бұрын

Continue please

@jadenbverghese8664 10 ай бұрын

Brilliant ! Thank you Dr Jain it was helpful.

@Dr.Loijing 9 ай бұрын

Thank you so much Sir🙏 please continue enlightening us with such priceless pearls

@TheICUChannel 9 ай бұрын

Thank you, we will try our best

@abhijitchatterjee7408 Жыл бұрын

❤️ bows to you.

@shilpadesai9962 11 ай бұрын

Thanks a lot sir Thanks for the wonderful teaching

@AumJi13 Жыл бұрын

How long after correcting for pH, with either Bicarbonate infusion (for acidosis) or fluids (for alkalosis), should we check/re-check the potassium levels? Is it 30mins, 1hr, 2hr... etc... after starting bicarb or fluids? Or more? What is the guideline for this step?

@chairman-ccef7876 Жыл бұрын

Excellent question. Transcellular movement occurs in minutes so an hour should be good

@AumJi13 Жыл бұрын

@@chairman-ccef7876thank you so much Sir! Much appreciated!

@hemantingole4033 Жыл бұрын

Thank you sir

@Archer396 Жыл бұрын

Really extra edge! Thanks to the team🎉

@allahhuakbar7362 3 ай бұрын

Extremely crucial😊

@umeshnagpal1332 Жыл бұрын

Nice video sir , very knowledgeable. Please sir make a video on hypo/ hypernatremia

@chairman-ccef7876 Жыл бұрын

Thanks for the suggestions

@rachanagupta6628 10 ай бұрын

Excellent information sir Thanks

@MegaPyrrhus Жыл бұрын

Hi Sir, I am a critical care fellow from Pakistan. This pearl is very fascinating and new to me. I didn't find this thing even in Parillo (textbook of CCM) and Washington Manual. Can you please provide the reference of an article or book on this? Your youtube channel has always been helpful to me. Thank you.

@TheICUChannel Жыл бұрын

It’s mentioned in almost every standard textbook . But for sake of reference, quoting uptodate link , www.uptodate.com/contents/potassium-balance-in-acid-base-disorders

@MegaPyrrhus Жыл бұрын

Thank you, Sir.

@DrPrabhuSingh Жыл бұрын

🎉 thanks Team, esteemed sir❤

@dr.shivarajvuppin2798 Жыл бұрын

Thanks for the precious information sir, it would be much more helpful if u share the relevant litrature or links , so tat we can read more about it and can discus in hospitals with seniors

@chairman-ccef7876 Жыл бұрын

True. Will keep that in mind. Problem is that there is no single source. Its the amalgamation of 35 years of prolific reading and bedside experience.

@rajibhowlader2899 Жыл бұрын

Today's Learning.. ❤❤❤

@nishantdeshpande6666 11 ай бұрын

Thank you for valuable information sir.

@gheorghealexandrucristian 7 ай бұрын

Thank you for the knowledge!

@Ignatius7778 Жыл бұрын

Brilliant 👏 👏. ECG also plays an important role in potassium management

@chairman-ccef7876 Жыл бұрын

Yes it does. 😊. But the importance is over emphasised in books.

@TheICUChannel Жыл бұрын

yes ECG is important , because if ECG changes are coming, means its alarming and you need to act on it.

@chairman-ccef7876 Жыл бұрын

In my opinion, ECG changes only imply acute K elevation. Nothing more. So serious life threatening hyperkalemia (say in chronic Renal Disease, where the rise is gradual) may occur with NO ECG changes. So if No ECG changes, you have time to correct and I would consider say dialysis. When ECG changes are there, hyperkalemia is acute and medical management becomes an emergency.

@mahanteshvarute359 4 ай бұрын

Useful lesson

@TheICUChannel 4 ай бұрын

Glad to hear that

@psthankaraj3887 10 ай бұрын

Excellent

@moulisankar7244 Жыл бұрын

Thank you so much sir 🙏

@chineduekwueme1837 Жыл бұрын

Lovely video. Thanks

@THEANESTHESIST 10 ай бұрын

What is low anion gap metabolic acidosis(LAGMA)? is there any term like this in the books?

@mikuprateek3886 Жыл бұрын

Very nice concept sir..

@TheICUChannel Жыл бұрын

Thank u. And yeah, it’s very important

@ZahidHussain-ht4tw Жыл бұрын

Thank you so much sir 👍👍👍

@pradeepjoshi969 11 ай бұрын

Sir,would like to have many more such short videos. please give links for the same

@moiznauman5121 9 ай бұрын

thank u Sir

@TheICUChannel 9 ай бұрын

Welcome

@arslanali1432 Жыл бұрын

Thanks for the video.Really learnt something important Can you kindly tell from where to study these facts.. Any book, article, guidelines Thanks

@chairman-ccef7876 Жыл бұрын

Not many books that give such pearls though information drowned in a lot of other information. This site is an excellent source. 😊😊😊

@anandtiwari52 3 ай бұрын

Extremely low tolerance for error......a whole book in one sentence......

@bardaasht007 10 ай бұрын

Good evening sir Greetings from pune Really very educational video and an eye opener, Can the same principle be applied In case of DKA with T2DM with CKD stage 4-5, with metabolic acidosis , where deranged RFT, hyperkalaemia is very common occurrence. Keen to know the management of such cases

@nikhilsss 10 ай бұрын

The uptodate article which was quoted mentions the correction is originally based on one study with less than 10 patients with a broad range and this number taken was the mean of that range. Even if that be, the change in pH, for example acidosis, would cause extracellular shift of potassium, rising serum potassium levels. So we are never really worried about the ' intracellular potassium'. The K+ outside (extracellular) is the one causing problems, which we correct routinely. So if potassium is 7 and corrected is 5, wouldn't that give a false sense of security? Or am I missing something entirely?

@anupamhalder475 11 ай бұрын

Beautiful

@adityamaindarge908 6 ай бұрын

Woww

@viswanathselvam2986 Жыл бұрын

Sir, isn't it the hyperkalemia in acidosis cause arrhythmias? Aren't we be worried about this when the K+ is 6.2meq/l?

@LearningCriticalCarewithCCEF Жыл бұрын

The Hyperkalemia in DKA is just a transcellelar shift that gets rapidly corrected once DKA treatment is started. In the example I gave, the corrected S.K was actually low. So its risky to try and reduce serum K when it is infact low. Does that clarify your doubt?

@KashifKxhan Ай бұрын

Can someone explain in detail how to correct pottasium with PH ?

@annmariesossong4245 6 ай бұрын

I have never heard this! Where can I read about it more? Do you have a link? Thank you so much for this.

@TheICUChannel 6 ай бұрын

Any standard ABG book .

@nikhiltrivedi1436 11 ай бұрын

One doubt In DKA when we plan to start Insulin Infusion we see the potassium before it so that potassium is the one that comes in ABG or the corrected one!

@ahmadgumman3390 11 ай бұрын

How come uptodate tells us to correct the hyperKalemia with insulin😢😢😢I am confused kindly elaborate

@ranjithkumar-rm8zw 8 ай бұрын

This applies for only metabolic acid base disorders or also for respiray sir???

@funnyfun6482 10 ай бұрын

Pakka

@kushagarjuneja3300 Жыл бұрын

Such a crucial detail must say! Dr., just want to ask that we take the corrected K+ into account only for the ICU/ critical patients or for any such as non- critical inpatients and outpatients l? (Perhaps a very stupid question)

@chairman-ccef7876 Жыл бұрын

Will apply to anyone, but pH abnormalities more common when a person is critically ill

@poojanaresh4578 5 ай бұрын

Sir, then if pt is posted for surgery and no time to correct alkalosis and hypokalemia, can we go ahead without fearing arrythmias??

@TheICUChannel 5 ай бұрын

In emergency u have to do your best with ongoing corrections … in elective cases , u need to optimise as much as u can .

@drbhushan146 Жыл бұрын

🙏🤝

@saumyajitbhaduri1083 10 ай бұрын

❤❤❤

@ahmadgumman3390 11 ай бұрын

Kindly share reference please

@srikrishnareddy879 Жыл бұрын

🙏

@jnanamaninanaiah742 11 ай бұрын

🙏💐

@chandrashekharrawat1870 Жыл бұрын

कृतज्ञ हुआ

@GauravKumar-st1cd Жыл бұрын

Books cannot beat experience

@chairman-ccef7876 Жыл бұрын

Well said

@chairman-ccef7876 Жыл бұрын

So true

@EDCRITICALCARE Жыл бұрын

Considering same example if serum potassium is 8.5 n pH is 6.9, shouldn't we correct potassium level? Corrected potassium will be 5.

@chairman-ccef7876 Жыл бұрын

Definitely should be corrected. You answered the question yourself. The corrected K is high now. Justifies cautious correction.

@drsunilkumarkedia Жыл бұрын

Sir 0.1 pH down will increase potassium by 0.7 . Am I right

@drsunilkumarkedia Жыл бұрын

Then in example it will be 0.5*0.7=0.35

@chairman-ccef7876 Жыл бұрын

@cuteboy3dbax6year9 you are making a mistake. Your statement is right. Drop in pH by 0.1 increases the k by 0.7 mEw/L. Here it is 5 times 0.1, so increase of K will be 5 x 0.7 = 3.5 mEw/L.

@chairman-ccef7876 Жыл бұрын

Typo error. Please read mEq/L