Formulas

Acid/Base

  • Winter's equation:
    • Expected pCO2 = 1.5 * [HCO3-] + 8 (+/-2)
      • If the measured PaCO2 is less than the expected → concurrent respiratory alkalosis
      • If the measured PaCO2 is more than the expected → concurrent respiratory acidosis

Burn

  • Parkland formula: Fluid Requirements = TBSA burned(%) x Wt (kg) x 4mL
    • Give 1/2 of total requirements in 1st 8 hours, then give 2nd half over next 16 hours.

Cardiovascular

  • O2 content = (Hb x 1.34 x SaO2) + (PaO2 x 0.003)
  • Mean Arterial Pressure = 1/3(SBP) + 2/3(DBP)

Endocrinology

  • Estimated average glucose from Hgb A1C = (28.7 X A1CUS units) - 46.7

FEN

  • Anion gap = Na – (Cl + HCO3-)
    • Corrected anion gap, mEq/L = Anion gap, mEq/L + [ 2.5 × (4 – albumin, g/dL) ]
    • Delta gap = Anion gap – 12 (normal anion gap)
  • Bicarbonate deficit = 0.4 × body weight in kg × (24 – bicarbonate level)
  • Calculated serum osmolality = 2 (Na) + Urea + Glucose
    • Normal = 280 - 300 mmol/l
  • Fractional Excretion of Sodium (FENa)% = 100 × (SCr × UNa ) / (SNa × UCr)
  • Maintenance fluids, calculated using the “4-2-1” Rule:
    • For 0-10 kg: + 4 mL/kg/hr
    • For 10-20 kg: + 2 mL/kg/hr
    • For >20 kg: + 1 mL/kg/hr
  • Corrected Sodium (Hillier, 1999) = Measured sodium + 0.024 * (Serum glucose - 100)
  • Corrected Calcium = (0.8 * (Normal Albumin - Pt's Albumin)) + Serum Ca
  • Free Water Deficit in Hypernatremia
    • FW Deficit (Adult Male) = 0.6 x weight (kg) x (current NA / 140-1)
    • FW Deficit (Adult Female) = 0.5 x weight (kg) x (current NA / 140-1)
    • FW Deficit (Elderly Male) = 0.5 x weight (kg) x (current NA / 140-1)
    • FW Deficit (Elderly Female) = 0.45 x weight (kg) x (current NA / 140-1)
    • FW Deficit (Child) = 0.6 x weight (kg) x (current NA / 140-1)

General

Note: this formula is only an approximation, and is generally only applicable for people 60 inches (5 foot) tall or greater.

Neurology

Cerebral Perfusion Pressure = MAP – ICP

Pulmonary

  • Alveolar-arterial O2 gradient, pATM at sea level 760 mmHg
    • PAO2 - paO2
    • A-a O2 gradient = [FiO2 x (pATM - pH2O)] - (paCO2/0.8) - paO2
    • =[FiO2 x (760 - 47)] - (paCO2/0.8) - paO2
    • Normal for young adult non-smoker < 15 mmHg at sea level at RA
    • Normal estimate by age < (age/4) + 4[1]
  • Expected Peak Flow:
    • PEFR, children = [(Height in cm - 100) × 5] + 100
    • PEFR, adult men = {[(Height in m × 5.48) + 1.58] - [Age × 0.041]} × 60
    • PEFR, adult women = {[(Height in m × 3.72) + 2.24] - [Age × 0.03]} × 60

Renal

  • Cockcroft-Gault CrCl, mL/min = (140 – age) × (weight, kg) × (0.85 if female) / (72 × Cr)

References

  1. Nickson C. Lifeinthefastlane. A-a gradient. http://lifeinthefastlane.com/ccc/a-a-gradient/.