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Acid-Base and Electrolyte Disorders in Neurocritical Care

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Neurocritical Care for Neurosurgeons

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Abstract

Electrolyte and acid-base disorders are very common in daily clinical practice. Although these abnormalities can be ascertained from routine laboratory findings, only specific clinical correlates may attest their significance. Acute electrolyte and acid-base disturbances may affect the peripheral nervous system causing areflexic weakness (hypermagnesemia, hyperkalemia, and hypophosphatemia), the central nervous system causing epileptic encephalopathies (hypomagnesemia, dysnatremias, and hypocalcemia), or both as a mixture of encephalopathy and weakness/paresthesias (hypocalcemia, alkalosis). Disabling complications may develop not only when these derangements are overlooked and left untreated (e.g., visual loss from intracranial hypertension in respiratory or metabolic acidosis; quadriplegia with respiratory insufficiency in hypermagnesemia) but also when they are inappropriately managed (e.g., central pontine myelinolysis when rapidly correcting hyponatremia and cardiac arrhythmias when aggressively correcting hypo- or hyperkalemia).

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Author information

Authors and Affiliations

  1. Division of Neurological Surgery, University of São Paulo, São Paulo, Brazil

    Renata Harumi Gobbato Yamashita, Vitor Nagai Yamaki, Nícollas Nunes Rabelo & Eberval Gadelha Figueiredo

  2. Neurological Surgery Department, State University of Ponta Grossa, Ponta Grossa, Brazil

    Leonardo C. Welling

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  1. Renata Harumi Gobbato Yamashita
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  2. Vitor Nagai Yamaki
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  3. Nícollas Nunes Rabelo
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  4. Leonardo C. Welling
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  5. Eberval Gadelha Figueiredo
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Editors and Affiliations

  1. University of São Paulo, São Paulo, Brazil

    Eberval Gadelha Figueiredo

  2. State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil

    Leonardo C. Welling

  3. University of Sao Paulo, São Paulo, São Paulo, Brazil

    Nícollas Nunes Rabelo

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Yamashita, R.H.G., Yamaki, V.N., Rabelo, N.N., Welling, L.C., Figueiredo, E.G. (2021). Acid-Base and Electrolyte Disorders in Neurocritical Care. In: Figueiredo, E.G., Welling, L.C., Rabelo, N.N. (eds) Neurocritical Care for Neurosurgeons. Springer, Cham. https://doi.org/10.1007/978-3-030-66572-2_21

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