How do you test for pseudohyponatremia?
How do you test for pseudohyponatremia?
Pseudohyponatremia is an artefact; measured serum sodium is reduced but actual plasma sodium is normal. The condition can only arise if the serum lipid or protein concentration is markedly increased and plasma sodium is measured using either indirect ISE or flame photometer.
How does glucose cause pseudohyponatremia?
The physics of osmosis will pull water into the serum to dilute the glucose in an attempt to equate the concentrations between the two fluid compartments. As it does, the incoming water also dilutes the sodium concentration within the plasma, resulting in a relative, “false” hyponatremia.
How do you calculate corrected glucose?
Formula Used: Sodium Correction = measured Na + [(glucose level – 100) x 0.016]
How do you calculate corrected sodium for glucose?
The proposed formula was: corrected sodium = measured sodium + [1.6 (glucose – 100) / 100]. The laboratory would then report a “corrected” serum or plasma sodium in addition to the measured sodium.
How do you code pseudohyponatremia?
ICD-10-CM Diagnosis Code E34 E34.
How is serum osmolality calculated?
Specific therapies and toxins that affect an individual’s fluid balance should also be evaluated with serum osmolality. The 1975 Dorwart and Chalmers formula, serum osmolality = 1.86(Na) + (glucose/18) + (BUN/2.8) + 9 had been often used to calculate the plasma osmolality.
How do you calculate serum osmolality?
What causes pseudohyponatremia?
The most common cause of pseudohyponatremia is due to severely elevated levels of cholesterol. [2] In serum blood samples taken from patients with severe hypertriglyceridemia, the sample may appear overtly lipemic, hyper viscous, or discolored from the overwhelming presence of insoluble triglycerides.
How is hyponatremia correction calculated?
Formula for Sodium Correction
- Fluid rate (mL / hour) = [(1000) * (rate of sodium correction in mmol / L / hr)] / (change in serum sodium)
- Change in serum sodium = (preferred fluid selected sodium concentration – serum sodium concentration) / (total body water + 1)
How do you calculate sodium correction?
What is the ICD-10 CM code for pseudohyponatremia?
Can pseudohyponatremia cause seizures?
Severe and rapidly evolving hyponatremia may cause seizures, which are usually generalized tonic-clonic, and generally occur if the plasma sodium concentration rapidly decreases to <115 mEq/L.
What is the difference between measured and calculated osmolarity in pseudohyponatremia?
Measured osmolarity is normal in pseudohyponatremia but calculated osmolarity – based as it is on a erroneously low plasma sodium result – is reduced. An increased osmolar gap (i.e. the difference between measured and calculated osmolarity) suggests pseudohyponatremia.
What is the pathophysiology of pseudohyponatremia?
As the lipid or protein concentration increases, the plasma water content decreases and the error that pseudohyponatremia represents becomes ever larger. Significant pseudohyponatremia (or pseudonormonatremia) can occur in any clinical situation in which the serum lipid (triglyceride or cholesterol) or protein concentration is markedly increased.
Which rapid measurement is used to assess pseudohyponatremia?
Faye S, Payne R. Rapid measurement of serum water to assess pseudohyponatremia. Clin Chem 1986; 32: 983-86 Waugh WH. Utility of expressing serum sodium per unit of water in assessing hyponatremia. Metabolism 1969; 18: 706-12
Is pseudohyponatremia a sign of insulin deficiency in diabetic ketoacidosis?
Quite apart from its cautionary value, this case history highlights the potential for pseudohyponatremia in those suffering the severe metabolic effect of insulin deficiency known as diabetic ketoacidosis (DKA).