RD here! Thank you so much for posting this This is a topic I have struggled to find info on since becoming an RD! Quick question. After watching this with my coworkers, we are confused about calculating the total ion pool (including Cl/acetate from Aminosyn). It looks like you didn't take into account the Cl and acetate provided from the Amisoyn in the 1/3-2/3 example. We are confused about whether it's necessary to take into account the amino acid concentration of acetate/Cl in the calculation vs not. Thank you so much! And I hope this makes sense!
Great question! I think I understand what you're asking, but please let me know if I don't answer it. I chose to create a 1/3:2/3 ratio out of the remaining electrolytes (the 167 mEq that we got after subtracting the 36 mEq chloride and 80 mEq acetate). But, you could definitely create a 1/3:2/3 ratio from the entire ion pool, so the whole 283 mEq. It's just a bit more math- 283 x 0.33 = 93 mEq chloride (- 36 from amino acids)= 57 mEq chloride remaining for Na/K 238 x 0.67 = 190 mEq acetate (-80 from amino acids)= 110 mEq acetate remaining for Na/K Both options are acceptable, in my opinion! The 1/3:2/3 ratio is somewhat arbitrary anyway. Let me know if that answered your question. Thanks for watching! - Jean
THANK YOU. So helpful
RD here! Thank you so much for posting this This is a topic I have struggled to find info on since becoming an RD! Quick question. After watching this with my coworkers, we are confused about calculating the total ion pool (including Cl/acetate from Aminosyn). It looks like you didn't take into account the Cl and acetate provided from the Amisoyn in the 1/3-2/3 example. We are confused about whether it's necessary to take into account the amino acid concentration of acetate/Cl in the calculation vs not. Thank you so much! And I hope this makes sense!
Great question! I think I understand what you're asking, but please let me know if I don't answer it.
I chose to create a 1/3:2/3 ratio out of the remaining electrolytes (the 167 mEq that we got after subtracting the 36 mEq chloride and 80 mEq acetate).
But, you could definitely create a 1/3:2/3 ratio from the entire ion pool, so the whole 283 mEq. It's just a bit more math-
283 x 0.33 = 93 mEq chloride (- 36 from amino acids)= 57 mEq chloride remaining for Na/K
238 x 0.67 = 190 mEq acetate (-80 from amino acids)= 110 mEq acetate remaining for Na/K
Both options are acceptable, in my opinion! The 1/3:2/3 ratio is somewhat arbitrary anyway. Let me know if that answered your question. Thanks for watching!
- Jean
thx guys continue pls
Max calcium for rule of thumb in 2:1 is 45 but for 3:1, i have been told its 35 meq per L. Curves will give you a better idea for sure!
Good