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Electrolyte Correction

Calculate Sodium Bicarbonate or Potassium correction.

Input Parameters

Select correction type and enter data.

Clinical Management of Electrolytes and Base Deficits on Cardiopulmonary Bypass

Physiological Principles & Clinical Context

The shifts in cellular membrane potentials, massive hemodilution, and cold cardioplegia administration during bypass can cause rapid, life-threatening changes in serum electrolytes. Hypokalemia increases myocardial tissue excitability and vulnerability to refractory arrhythmias upon cross-clamp removal, while hyperkalemia may cause myocardial conduction block and flatline arrest. Base deficits (representing metabolic acidosis) often develop secondary to systemic tissue hypoperfusion or cellular hypoxia. Deficit corrections must be carefully calculated using extracellular distribution factors to restore standard values.

Clinical Targets & Safe Ranges

  • •Serum Potassium (K⁺) Target: 4.0 to 5.0 mEq/L
  • •Serum Sodium (Na⁺) Target: 135 to 145 mEq/L
  • •Serum Ionized Calcium (iCa) Target: 1.10 to 1.30 mmol/L on bypass to preserve cardiac contractility.
  • •Metabolic Base Deficit Threshold: Treatment is generally indicated when Base Excess is more negative than -4 to -5 mEq/L.

Mathematical Formulation

  • ƒSodium Bicarbonate Correction: Bicarbonate Dose (mEq) = Patient Weight (kg) × Base Deficit × 0.3
  • ƒPotassium Deficit Correction: K⁺ Deficit (mEq) = (Target K⁺ - Current K⁺) × Patient Weight (kg) × 0.4
  • ƒBicarbonate Distribution Space: 0.3 represents the extracellular fluid volume percentage of body weight.
  • ƒPotassium Distribution Space: 0.4 represents the total body water distribution factor for potassium.

Academic & Clinical References

  1. Marino PL. The ICU Book. 4th ed. Philadelphia: Wolters Kluwer; 2014.
  2. Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med. 2000;342(21):1581-1589.
  3. Adrogué HJ, Madias NE. Hypernatremia. N Engl J Med. 2000;342(20):1493-1499.