How do you calculate corrected sodium in DKA?

How do you calculate corrected sodium in DKA?

​A question recently posted on AACC’s chemistry list-serve involved correcting the serum or plasma sodium concentration for the patient’s degree of hyperglycemia in the setting of DKA. The proposed formula was: corrected sodium = measured sodium + [1.6 (glucose – 100) / 100].

Why do you need to correct sodium for hyperglycemia?

Because hyperglycemia can depress sodium concentration, patients with hyponatremia might be overlooked during severe hyperglycemia. We hypothesized that the corrected serum sodium level for severe hyperglycemia should be a prognostic factor to predict clinical outcomes in severe hyperglycemic patients.

When do you use corrected sodium?

sodium concentration to calculate the anion gap,1 and use the corrected sodium concentration to estimate the severity of dehydration in severe hyperglycemia.

Do you correct sodium for anion gap calculation?

Should the corrected sodium be used for calculating the anion gap? No! The anion gap reflects the balance between positively and negatively charged electrolytes in the extracellular fluid. Glucose is electrically neutral and does not directly alter the anion gap.

Why do we correct sodium in DKA?

The corrected [Na], computed as [Na] increase by 1.6 mmol/L per 5.6 mmol/L decrease in [Glu], provides a reasonable estimate of the degree of hypertonicity due to losses of hypotonic fluids through osmotic diuresis at presentation of DKH or HHS and should guide the tonicity of replacement solutions.

Why is sodium low in DKA?

In DKA, we expect to find normal or low serum sodium due to the dilutional effect of hyperosmolar status caused by elevated blood glucose that shifts water from the intracellular space to the extracellular space.

Do you correct sodium for anion gap with hyperglycemia?

Serum sodium in these patients should not be corrected for hyperglycemia to calculate the anion gap for acidosis because extracellular fluid shifts caused by hyperglycemia will dilute serum chloride and bicarbonate.

What is the anion gap for DKA?

In mild DKA, anion gap is greater than 10 and in moderate or severe DKA the anion gap is greater than 12. These figures differentiate DKA from HHS where blood glucose is greater than 600 mg/dL but pH is greater than 7.3 and serum bicarbonate greater than 15 mEq/L.

What is the sodium correction for hyperglycemia?

The Sodium Correction for Hyperglycemia Calculates the actual sodium level in patients with hyperglycemia. MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice.

What is the formula for calculating corrected sodium?

Corrected Sodium = Measured sodium + (((Serum glucose – 100)/100) x 1.6)

What are the diagnostic criteria for diabetic ketoacidosis (DKA)?

The American Diabetes Association diagnostic criteria for DKA are as follows: ✓ Elevated serum glucose level; greater than 250 mg/dL (13.88 mmol/L); ✓ Serum bicarbonate level less than 18 mEq/L (18 mmol/L).

Can sodium correction be done too quickly in hyponatremia?

Overly rapid correction, particularly in chronic hyponatremia, can lead to osmotic demylination syndrome (ODS), previously known as central pontine myelinolysis (CPM). In most cases, sodium correction should be done in an ICU setting, especially with hypertonic fluids for replacement. Please fill out required fields. Correct hyponatremia carefully.

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