ICU · Pharmacology

Electrolyte Therapy — Sodium, Potassium, Magnesium, Calcium & Phosphate

Also known as Electrolyte therapy · Potassium replacement · Hypokalaemia · Hyperkalaemia · Hyponatraemia · Hypernatraemia · Magnesium · Calcium · Phosphate · Hypophosphataemia

Electrolyte therapy in the ICU: sodium (hyponatraemia - 3% saline 100 mL boluses for severe symptomatic, correction capped at 10 mmol/L in the first 24 h, osmotic demyelination risk; hypernatraemia - free-water deficit, correct no faster than 0.5 mmol/L per hour), potassium (rate-limited IV replacement, never a bolus, fix Mg first; hyperkalaemia - calcium stabilise, then insulin/dextrose with salbutamol shift, then remove), magnesium (MgSO4 4 g load + 1-2 g/h; hypermagnesaemia - stop infusion, dialysis if severe), calcium (treat the ionised fraction; hypocalcaemia - IV calcium for symptomatic; hypercalcaemia - hydration + bisphosphonate, zoledronate 4 mg), phosphate (hypophosphataemia - respiratory muscle weakness, IV replacement when severe, refeeding syndrome prevention with thiamine and electrolyte monitoring).

Checked against its sources on 1 Sept 2026