Electrolyte Management for Medical Students and Residents: Beyond the Basics!

[@itsneuro]

M3 here-there is increasing evidence that we should NOT be correcting calcium for albumin levels, especially in critically ill patients! The reason for this is that pH and levels of other small anions (phosphate, lactate, etc.) modulate the binding of calcium to albumin and the simple 0.8 correction factor equation we’re taught in med school does not account for these. In addition, the binding between calcium and albumin is not a linear relationship as the correction equation assumes. If there’s any concern of hypocalcemia, it’s always better just to check an ionized calcium and going from there.