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

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  • Опубліковано 28 вер 2024
  • How to correct potassium as per pH in ABG i.e. in acidosis and alkalosis in ICU; explained by Dr. P.K.Jain
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    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
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    ESBICM Team, esbicm.com | icu.in
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КОМЕНТАРІ • 112

  • @vijayalakshmicmsunderaj595
    @vijayalakshmicmsunderaj595 Рік тому +19

    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.

  • @swaroopak8368
    @swaroopak8368 Місяць тому

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

  • @sanjoyghosh2183
    @sanjoyghosh2183 Рік тому +1

    Priceless piece of information Sir

  • @tradingchannell
    @tradingchannell Рік тому

    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.shivarajvuppin2798
    @dr.shivarajvuppin2798 Рік тому +1

    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
      @chairman-ccef7876 Рік тому +3

      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.

  • @mahanteshvarute359
    @mahanteshvarute359 5 місяців тому

    Useful lesson

  • @Archer396
    @Archer396 Рік тому

    Really extra edge! Thanks to the team🎉

  • @nishantdeshpande6666
    @nishantdeshpande6666 Рік тому

    Thank you for valuable information sir.

  • @amna.ejaz10
    @amna.ejaz10 Рік тому

    Thank you so much sir

  • @ZahidHussain-ht4tw
    @ZahidHussain-ht4tw Рік тому

    Thank you so much sir 👍👍👍

  • @bardaasht007
    @bardaasht007 11 місяців тому

    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

  • @kamal7835
    @kamal7835 Рік тому

    Thanks a lot sir❤

  • @AumJi13
    @AumJi13 Рік тому +3

    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
      @chairman-ccef7876 Рік тому +3

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

    • @AumJi13
      @AumJi13 Рік тому

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

  • @viswanathselvam2986
    @viswanathselvam2986 Рік тому +2

    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
      @LearningCriticalCarewithCCEF Рік тому +1

      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?

  • @ahmadgumman3390
    @ahmadgumman3390 Рік тому

    Kindly share reference please

  • @jnanamaninanaiah742
    @jnanamaninanaiah742 Рік тому

    🙏💐

  • @chandrashekharrawat1870
    @chandrashekharrawat1870 Рік тому

    कृतज्ञ हुआ

  • @drMahroshFalak
    @drMahroshFalak Рік тому +6

    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.

  • @KashifKxhan
    @KashifKxhan 2 місяці тому

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

  • @THEANESTHESIST
    @THEANESTHESIST 11 місяців тому +1

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

  • @poojanaresh4578
    @poojanaresh4578 6 місяців тому

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

    • @TheICUChannel
      @TheICUChannel  6 місяців тому

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

  • @drnaseemuddinkalhoro3542
    @drnaseemuddinkalhoro3542 6 місяців тому +1

    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

  • @annmariesossong4245
    @annmariesossong4245 8 місяців тому

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

  • @widaltyph491
    @widaltyph491 Рік тому +2

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

  • @nikhilsss
    @nikhilsss 11 місяців тому

    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?

  • @sultanzaffar1017
    @sultanzaffar1017 2 місяці тому +1

    Great I really enjoyed your short lecture

  • @PratyushChaudhuri
    @PratyushChaudhuri Місяць тому

    Thank you

  • @mukundrajta2576
    @mukundrajta2576 Рік тому +2

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

  • @MegaPyrrhus
    @MegaPyrrhus Рік тому +2

    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
      @TheICUChannel  Рік тому +3

      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
      @MegaPyrrhus Рік тому

      Thank you, Sir.

  • @meeradewangan5862
    @meeradewangan5862 Рік тому +1

    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

  • @chandrakantchandak
    @chandrakantchandak Рік тому +5

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

  • @chamariliyanage9626
    @chamariliyanage9626 Рік тому +1

    It really worth,Thank you so much sir.

  • @Archer396
    @Archer396 Рік тому +2

    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
      @chairman-ccef7876 Рік тому

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

    • @Archer396
      @Archer396 Рік тому

      @@chairman-ccef7876 yes yes

  • @arslanali1432
    @arslanali1432 Рік тому +1

    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
      @chairman-ccef7876 Рік тому

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

  • @ahmadgumman3390
    @ahmadgumman3390 Рік тому

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

  • @umeshnagpal1332
    @umeshnagpal1332 Рік тому +1

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

  • @haha..551
    @haha..551 Рік тому +1

    Excellent information 👍

  • @EDCRITICALCARE
    @EDCRITICALCARE Рік тому +1

    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
      @chairman-ccef7876 Рік тому

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

    • @drsunilkumarkedia
      @drsunilkumarkedia Рік тому

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

    • @drsunilkumarkedia
      @drsunilkumarkedia Рік тому

      Then in example it will be 0.5*0.7=0.35

    • @chairman-ccef7876
      @chairman-ccef7876 Рік тому +1

      @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
      @chairman-ccef7876 Рік тому

      Typo error. Please read mEq/L

  • @Dr.Amritkumaryadav
    @Dr.Amritkumaryadav Рік тому +1

    Very valuable information indeed

  • @anandtiwari52
    @anandtiwari52 4 місяці тому

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

  • @hemantingole4033
    @hemantingole4033 Рік тому +1

    Thank you sir

  • @drbhushan146
    @drbhushan146 Рік тому +1

    🙏🤝

  • @nikhiltrivedi1436
    @nikhiltrivedi1436 Рік тому

    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!

  • @RaviKumar-ml8ob
    @RaviKumar-ml8ob 2 місяці тому

    Thank you so much sir, excellent sir

  • @ranjithkumar-rm8zw
    @ranjithkumar-rm8zw 10 місяців тому

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

  • @pradeepjoshi969
    @pradeepjoshi969 Рік тому

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

  • @abhijitchatterjee7408
    @abhijitchatterjee7408 Рік тому +1

    ❤️ bows to you.

  • @tusharchopawar8255
    @tusharchopawar8255 Рік тому

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

  • @saminkazi4999
    @saminkazi4999 Рік тому +1

    Wonderful explanation

  • @faizdr1723
    @faizdr1723 5 місяців тому

    Well done sir
    May Allah grant you long healthy life

  • @shubhamtripathi405
    @shubhamtripathi405 3 місяці тому

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

  • @shilpadesai9962
    @shilpadesai9962 Рік тому

    Thanks a lot sir
    Thanks for the wonderful teaching

  • @jadenbverghese8664
    @jadenbverghese8664 11 місяців тому

    Brilliant ! Thank you Dr Jain it was helpful.

  • @rachanagupta6628
    @rachanagupta6628 Рік тому

    Excellent information sir Thanks

  • @kushagarjuneja3300
    @kushagarjuneja3300 Рік тому

    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
      @chairman-ccef7876 Рік тому

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

  • @nandan0000s
    @nandan0000s Рік тому

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

  • @Bunicutaintelectuala
    @Bunicutaintelectuala 9 місяців тому

    Thank you for the knowledge!

  • @allahhuakbar7362
    @allahhuakbar7362 4 місяці тому

    Extremely crucial😊

  • @moulisankar7244
    @moulisankar7244 Рік тому

    Thank you so much sir 🙏

  • @hishighnessab5540
    @hishighnessab5540 8 місяців тому

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

  • @LoijingandVsay
    @LoijingandVsay 10 місяців тому

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

    • @TheICUChannel
      @TheICUChannel  10 місяців тому

      Thank you, we will try our best

  • @adityamaindarge908
    @adityamaindarge908 7 місяців тому

    Woww

  • @rajibhowlader2899
    @rajibhowlader2899 Рік тому

    Today's Learning.. ❤❤❤

  • @chineduekwueme1837
    @chineduekwueme1837 Рік тому

    Lovely video. Thanks

  • @DrPrabhuSingh
    @DrPrabhuSingh Рік тому

    🎉 thanks Team, esteemed sir❤

  • @saumyajitbhaduri1083
    @saumyajitbhaduri1083 Рік тому

    ❤❤❤

  • @funnyfun6482
    @funnyfun6482 Рік тому

    Pakka

  • @KarthikArjun991991
    @KarthikArjun991991 Рік тому

    Thank you Sir🙏

  • @mohitaggarwal4731
    @mohitaggarwal4731 Рік тому

    Thanks sir

  • @anupamhalder475
    @anupamhalder475 Рік тому

    Beautiful

  • @psthankaraj3887
    @psthankaraj3887 Рік тому

    Excellent

  • @shubhamsingh-xk4br
    @shubhamsingh-xk4br 6 місяців тому

    Thank you so much sir

  • @srikrishnareddy879
    @srikrishnareddy879 Рік тому

    🙏

  • @Ignatius7778
    @Ignatius7778 Рік тому

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

    • @chairman-ccef7876
      @chairman-ccef7876 Рік тому

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

    • @TheICUChannel
      @TheICUChannel  Рік тому +1

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

    • @chairman-ccef7876
      @chairman-ccef7876 Рік тому +1

      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.

  • @moiznauman5121
    @moiznauman5121 10 місяців тому

    thank u Sir

  • @mikuprateek3886
    @mikuprateek3886 Рік тому

    Very nice concept sir..

  • @GauravKumar-st1cd
    @GauravKumar-st1cd Рік тому +1

    Books cannot beat experience