{"podcast":{"title":"Channel Your Enthusiasm","slug":"channel-your-enthusiasm-1374325","podcast_index_feed_id":1374325,"rss_url":"http://www.rosebook.club/episodes/?format=rss","website_url":"http://www.rosebook.club/episodes/","image_url":"https://images.squarespace-cdn.com/content/v1/548bc7f6e4b0a269c594ebc2/1611689941077-BL32D22Z1P27G4UAVKEE/Screen+Shot+2021-01-26+at+2.34.41+PM.png?format=1500w","author":"joel topf","episode_count":31,"summary":"A chapter by chapter recap of Burton Rose’s classic, The Clinical Physiology of Acid Base and Electrolyte Disorders, a kidney physiology book for nephrologists, fellows, residents and medical students.","last_synced_at":null,"page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325"},"episode":{"title":"Chapter Fourteen:  Hypovolemic States, part 2","slug":"chapter-fourteen-hypovolemic-states-part-2","published_at":"2024-03-24T17:14:39+00:00","page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-fourteen-hypovolemic-states-part-2","show_page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325","url":"http://www.rosebook.club/episodes/2024/3/24/chapter-fourteen-part-2","audio_url":"https://chrt.fm/track/47G747/static1.squarespace.com/static/548bc7f6e4b0a269c594ebc2/t/66005ec4b44e441e06b15a60/1715396458586/Chapter+14.2.mp3","summary":"Outline Chapter 14 — Treatment - Treatment - Both oral and IV treatment can be used for volume replacement - The goal of therapy are to restore normovolemia - And to correct associated acid-base and electrolyte disorders - Oral Therapy - Usually can be accomplished with increased water and dietary sodium - May use salt tablets - Glucose often added to resuscitation fluids - Provides calories - Promotes intestinal Na reabsorption since there is coupled Na and Glucose similar to that seen in the proximal tubule - Rice based solutions provide more calories and amino acids which also promote sodium reabsorption - 80g/L of glucose with rice vs 20 g/L with glucose alone - IV therapy - Dextrose solutions - Physiologically equivalent to water - For correcting hypernatremia - For covering insensible losses - Watch for hyperglycemia - Footnote warns against giving sterile water - Saline solutions - Most hypovolemic patients have a water and a sodium deficit - Isotonic saline has a Na concentration of 154, similar to that of plasma see page 000 - Half-isotonic saline is equivalent to 550 ml of isotonic saline and 500 of free water. Is that a typo? - 3% is a liter of hypertonic saline and 359 extra mEq of Na - Dextrose in saline solutions - Give a small amount of calories, otherwise useless - Alkalinizing solutions - 7.5% NaHCO3 in 50 ml ampules 44 mEq of Na and 44 mEq of HCO3 - Treat metabolic acidosis or hyperkalemia - Why 44 mEq and not 50? - Do not give with calcium will form insoluble CaCO3 - Polyionic solutions - Ringers contains physiologic K and Ca - Lactated Ringers adds 28 mEq of lactate - Spreads myth of LR in lactic acidosis - Potassium chloride - Available as 2 mEq/mL - Do not give as a bolus as it can cause fatal hyperkalemia - Plasma volume expanders - Albumin, poly…","meta_description":"Outline Chapter 14 — Treatment - Treatment - Both oral and IV treatment can be used for volume replacement - The goal of therapy are to restore normovolem…","key_points":[],"chapters":[],"topics":[],"duration_seconds":5979,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/channel-your-enthusiasm-1374325/episodes/chapter-fourteen-hypovolemic-states-part-2/transcription-requests","description":"Idempotently request low-priority transcript generation for this episode."},{"name":"read_markdown","method":"GET","url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-fourteen-hypovolemic-states-part-2.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}