iMg and other Electrolyte Abnormalities in Blood Gas Analysis
ON DEMAND - Nova Educational webinar series
Hypomagnesemia is common in critically ill patients undergoing renal replacement therapy (RRT) and is associated with increased risk of mortality. Measurement of total plasma magnesium (tMg) is the current clinical practice to assess hypomagnesemia in these patients. However, tMg does not accurately represent the level of ionized magnesium (iMg), the physiologically active fraction of magnesium in blood. Multiple reasons that favor iMg and not tMg in assessing RRT-related hypomagnesemia will be discussed. The webinar will describe an RRT patient population with consistently normal tMg but low iMg. These patients were undergoing continuous venovenous hemofiltration (CVVH) using citrate anticoagulation. In this population, iMg and not tMg was a better discriminating marker for hypomagnesemia and the requirement for magnesium supplementation. The superior detection of hypomagnesemia through iMg testing has particular application to COVID-19 patients since this group often requires a higher citrate concentration during CVVH.
Speaker: Wouter Tiel Groenestege, PhD
Clinical Chemist, Central Diagnostic Laboratory, University Medical Center, Utrecht, Netherlands
Evaluating a patient’s intravascular volume status is an essential component of the overall assessment of a patient and is critical to establishing a treatment plan. This is especially true for critically ill patients, septic patients, postoperative patients, and patients with heart failure or kidney disease, to name a few. This webinar will review the methods available for assessing plasma volume status (PVS) and the evidence for their clinical utility.
Mitchell Rosner, MD, MACP
Henry B. Mulholland Professor of Medicine, Chair,
Department of Medicine, University of Virginia Health System
Early studies have reported various electrolyte abnormalities in patients who progress to the severe form of COVID-19. It has also been shown that pre-existent chronic kidney disease increases the risk of more severe COVID-19 complications. This webinar will discuss COVID-19 critical illness and its impact on electrolyte homeostasis and kidney function. We will describe the common electrolyte abnormalities, their pathophysiology and treatment recommendations. We will also describe the common finding of acute kidney injury (AKI) in COVID-19, its pathophysiology, and strategies to manage it in the acute care setting. A rapid blood analyzer for monitoring electrolytes, kidney function, blood gases and metabolites in acute care settings will be described.
Dennis Begos, MD, FACS, FACRS
Associate Medical Director, Medical and Scientific Affairs, Nova Biomedical
Most Comprehensive Critical Care Menu, Configurable for All Departments Comprehensive Critical Care Menu, Configurable for All Departments
PO2, PCO2, pH, Hct, tHb, Na, Cl, K, TCO2, iCa, iMg, Glu, Lac, SO2%,
O2Hb, COHb, MetHb, HHb, tBil, HbF