Me neither
I found this, however. Could you reply back and tell me if you'd worked with something like this before?
Similarly, here's another example:
What is the H+ deficit for this patient if you desire the [HCO3-] to be corrected to 35mEq/L?Solution
A. H+ deficit can be calculated by the following equation:
H+ deficit = 0.5 x Wt x ( [HCO3-]measured – [HCO3-] desired )
Therefore in our clinical example the H+ deficit follows:
H+ deficit = 0.5 (70) x (45 – 35)
= 0.5 (70) (10)
= 350 mEq
After having calculated the H+ deficit to correct the severe metabolic alkalosis to a desired [HCO3-] value, you are handed a dilute concentration of HCL. The next question that naturally follows is, HOW MUCH TO GIVE?!
Calculating the Volume of 0.1N HCL to infuse
Our previous patient who suffering from severe life threatening metabolic alkalosis has an ABG that reveals pH 7.59, [HCO3-] of 45 mEq/L. Having calculated the H+ deficit to correct the [HCO3-] from 45 mEq to 35 mEq, our next concern is to determine the volume of dilute HCL to be infused.
The volume of 0.1N HCL to be infused can be calculated by the following equation:
Volume of 0.1N HCL = H+ deficit / 100
In our clinical example, the patient has a H+ deficit of 350 mEq. Therefore the volume of 0.1N HCL to be infused to correct the [HCO3-] from 45 mEq/L to 35 mEq/L is:
Volume of 0.1N HCL = H+ deficit / 100
= 350 mEq / 100
= 3.5 Liters of 0.1N HCL
Rate of Infusion of 0.1N HCL
The rate of infusion of HCL should be less than 0.2 mEq/kg/hr!
Therefore for our 70kg patient:
70 kg x 0.2mEq/ kg/ hr = 14 mEq/hr.
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