Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Today Report Regarding Hypernatremia , He Was On The Management
Question: Today report
regarding hypernatremia, he was on the management with 5%DW and now coming down (160 to 148).
K+ is 5.5
We are doing lung and cardiac ultrasound daily.
Lung: multiple B lines bilaterally ,no pleural fluids
Cardiac: mild LV systolic dysfunctions;EF estimated >45%
IVC has significant respiratory variation.
We are giving him boluses fluid.
After discussing with our nephrologist, dialysis was started for the indications of acidosis(PH 7.165)
2hours dialysis with 200ml/min blood flow and dialysate flow rate 500ml/min with nill weight loss.He has tolerated.We will continue SLED/HD today also based on his vasopressor requirement.
He is on adrenaline because of the relative bradycardia (inferior infarction). Dobutamine is not available and it also keeps MAP in low range which is not quite ok for him.
Question
Does his his condition improving ? Or getting bad ?
Any explanation and additional advice.
Thank you !
regarding hypernatremia, he was on the management with 5%DW and now coming down (160 to 148).
K+ is 5.5
We are doing lung and cardiac ultrasound daily.
Lung: multiple B lines bilaterally ,no pleural fluids
Cardiac: mild LV systolic dysfunctions;EF estimated >45%
IVC has significant respiratory variation.
We are giving him boluses fluid.
After discussing with our nephrologist, dialysis was started for the indications of acidosis(PH 7.165)
2hours dialysis with 200ml/min blood flow and dialysate flow rate 500ml/min with nill weight loss.He has tolerated.We will continue SLED/HD today also based on his vasopressor requirement.
He is on adrenaline because of the relative bradycardia (inferior infarction). Dobutamine is not available and it also keeps MAP in low range which is not quite ok for him.
Question
Does his his condition improving ? Or getting bad ?
Any explanation and additional advice.
Thank you !
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
His situation seems to be similar to the previous reports.
The dialysis, which has been started, will help lower potassium levels and improve his hemodynamic situation.
Regarding his heart, his situation seems to be stable.
Lines B in the lungs , mean that pneumonia persists, but without pleural fluid.
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr.Iliri
I would explain as follows:
Detailed Answer:
Hello again!
His situation seems to be similar to the previous reports.
The dialysis, which has been started, will help lower potassium levels and improve his hemodynamic situation.
Regarding his heart, his situation seems to be stable.
Lines B in the lungs , mean that pneumonia persists, but without pleural fluid.
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr.Iliri
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
