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Fluid and Electrolyte Emergencies in Critically Ill Children Richard T. Blaszak, M.D.  Stephen M. Schexnayder, M.D.
Objectives ,[object Object],[object Object],[object Object],[object Object]
Case Study #1 ,[object Object],[object Object],[object Object],[object Object]
Case Study #1 What is your differential diagnosis? What diagnostic studies would you order?
Case Study #1 Differential diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #1 Laboratory studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #1 Laboratory studies ,[object Object],[object Object],[object Object],[object Object]
Case Study #1   Syndrome of Inappropriate Antidiuretic Hormone (SIADH) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #1   SIADH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #1   SIADH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #1   SIADH ,[object Object],[object Object],[object Object],[object Object]
Case Study #1 The saga continues…. ,[object Object],[object Object],[object Object]
Case Study #1 The saga continues ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #1 The saga continues ,[object Object],[object Object],[object Object]
Case Study #1   Hyponatremic seizure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #2 No one can obtain IV access after 15 minutes, what would you do now?
Case Study #2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #2 What is the most likely explanation of this patients acidosis?
Case Study #2 Metabolic acidosis and the anion gap ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
1. Normal gap 2. Increased gap ,[object Object],[object Object],2. GI “HCO 3 ” losses  Proximal RTA Distal RTA Diarrhea 1.    Acid prod 2.    Acid elimination Lactate DKA Ketosis Toxins Alcohols Salicylates Iron Renal disease Case Study #2 Metabolic acidosis and the anion gap
Case Study #3 ,[object Object],[object Object],[object Object],[object Object]
Case Study #3 Differential diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #3 Laboratory studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #3 Laboratory studies ,[object Object],[object Object],[object Object],[object Object]
Case Study #3 Diabetes Insipidus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #3 Diabetes Insipidus ,[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #4 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #4 What is your differential diagnosis? What diagnostic studies would you order?
Case Study #4 Differential diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #4 Laboratory studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #4 Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #4   Adrenal Insufficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #4   Adrenal Insufficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #4   Adrenal Insufficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #4   Adrenal Insufficiency ,[object Object]
Case Study #4   Adrenal Insufficiency ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #5 ,[object Object],[object Object],[object Object]
Case Study #5 Hyperkalemia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiac Monitor ,[object Object],[object Object]
Case Study #5 Hyperkalemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #6 ,[object Object],[object Object],[object Object],[object Object]
Case Study #6 Laboratory studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Study #6 Laboratory studies ,[object Object],[object Object],[object Object]
Case Study #6 Hypokalemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object]

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Fluid And Electrolyte Emergencies In Critically Ill Children

  • 1. Fluid and Electrolyte Emergencies in Critically Ill Children Richard T. Blaszak, M.D. Stephen M. Schexnayder, M.D.
  • 2.
  • 3.
  • 4. Case Study #1 What is your differential diagnosis? What diagnostic studies would you order?
  • 5.
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  • 17. Case Study #2 No one can obtain IV access after 15 minutes, what would you do now?
  • 18.
  • 19. Case Study #2 What is the most likely explanation of this patients acidosis?
  • 20.
  • 21.
  • 22.
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  • 27.
  • 28.
  • 29. Case Study #4 What is your differential diagnosis? What diagnostic studies would you order?
  • 30.
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  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.