Urinary Anion Gap
Urinary Anion Gap = [Na+]+ [K+] - [Cl-]
Category CCC
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Rapid Sequence Intubation (RSI)
Rapid sequence intubation (RSI) is an airway management technique that produces inducing immediate unresponsiveness (induction agent) and muscular relaxation (neuromuscular blocking agent) and is the fastest and most effective means of controlling the emergency airway
Sodium Bicarbonate Use
Sodium Bicarbonate Use. metabolic acidosis leads to adverse cardiovascular effects. bicarbonate must be administered in a solution as sodium bicarbonate
Respiratory Compensation in Metabolic Disorders
The extent of respiratory compensation for a metabolic disorder is determined by the balance between the abnormality in the pH (hence the drive to change) and how hard it is to get there (eg. work of respiratory muscles in hyperventilation)
Intubation, Hypotension and Shock
A modified rapid sequence intubation (RSI) approach is usually preferred in hypotensive, shocked patients
Respiratory Alkalosis
Respiratory Alkalosis = a primary acid-base disorder in which arterial pCO2 falls to a level lower than expected.
Rapid sequence airway (RSA) and PALM
Rapid sequence airway (RSA) is a modified form of rapid sequence intubation that uses an LMA inserted following induction (+/- administration of neuromuscular blockade) to maximise peri-intubation oxygenation prior to endotracheal tube insertion
Respiratory Acidosis
Respiratory acidosis = a primary acid-base disorder in which arterial pCO2 rises to an abnormally high level.
Pretreatment drugs for RSI
Traditionally there are four options for pretreatment for Rapid Sequence Intubation (RSI): atropine, lidocaine, fentanyl, and defasciculating dose of a non-depolarising neuromuscular blocker
Normal Anion Gap Metabolic Acidosis
Normal Anion Gap Metabolic Acidosis (NAGMA). HCO3 loss and replaced with Cl- -> anion gap normal. if hyponatraemia is present the plasma [Cl-] may be normal despite the presence of a normal anion gap acidosis -> this could be considered a 'relative hyperchloraemia'.
Preoxygenation
Preoxygenation is the administration of oxygen to a patient prior to intubation to extend 'the safe apnoea time'. The primary mechanism is 'denitrogenation' of the lungs, however maximal preoxygenation is achieved when the alveolar, arterial, tissue, and venous compartments are all filled with oxygen.
Metformin-associated Lactic Acidosis
Metformin use is associated with lactic acidosis, but it remains controversial as a disease entity