Sodium and Potassium Abnormalities

  • Caroline Park
  • Daniel Grabo


Managing electrolyte abnormalities effectively requires that the critical care surgeon understands the organization and equilibrium of intracellular and extracellular (including the interstitial and intravascular) fluid compartments. Fluid shifts and subsequent electrolyte derangements are common in the surgical patient in the postoperative period as well as in the trauma patient. Sodium is the predominant cation in the extracellular compartment, while potassium dominates the intracellular space. Derangements in sodium homeostasis (hypo- or hypernatremia) are largely related to volume status (hypo-, eu-, or hypervolemia) and as such can be treated with some measure of fluid restriction and diuretics or volume administration. As the major intracellular cation, potassium plays integral roles in nerve conduction, ATPase transmembrane pumps, and cardiac myocyte excitability. Seemingly minor changes in potassium levels (hyper- or hypokalemia) can have significant physiologic consequences. Accordingly, there are a multitude of options with which to replete potassium or shift its location either intracellular (insulin or albuterol) or out of the body (diuretics or dialysis).


Hyponatremia Hypernatremia Hypokalemia Hyperkalemia Fluid compartments 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Acute Care SurgeryLAC-USC Medical CenterLos AngelesUSA
  2. 2.Department of Trauma, Acute Care Surgery and Surgical Critical CareWest Virginia UniversityMorgantownUSA

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