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      Therapeutic Approach to Hypokalemia

      a , b
      S. Karger AG
      Replacement, Hypokalemia, Treatment, Potassium

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          For successful potassium replacement, one should consider the optimal potassium preparation, route of administration, and the appropriate speed of administration. In the absence of an independent factor causing transcellular potassium shifts, the plasma potassium concentration can be used as a rough index to estimate body potassium stores. Oral KCl replacement therapy is preferable if there are bowel sounds, except in the setting of life-threatening abnormalities such as ventricular arrhythmias, digitalis intoxication, or paralysis. In patients with impaired renal function or those treated with intravenous potassium, the risk of hyperkalemia should be monitored. Since potassium depletion rarely occurs as an isolated phenomenon, associated fluid and electrolyte disorders should be corrected, and the causes of potassium loss should be sought and eliminated to complete the treatment of hypokalemia.

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          Most cited references5

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            Preoperative Serum Potassium Levels and Perioperative Outcomes in Cardiac Surgery Patients

            Joyce Wahr (1999)
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              Rapid correction of hypokalemia using concentrated intravenous potassium chloride infusions.

              There are conflicting recommendations regarding the use of intravenous potassium chloride infusions for acute correction of hypokalemia. We examined the effects of 495 sets of potassium chloride infusions administered to a medical intensive care unit population. The infusion sets consisted of one to eight consecutive individual infusions, each containing 20 mEq of potassium chloride in 100 mL of saline administered. The mean preinfusion potassium level was 3.2 mmol/L, and the mean postinfusion potassium level was 3.9 mmol/L. The mean increment in serum potassium level per 20-mEq infusion was 0.25 mmol/L. No temporally related life-threatening arrhythmias were noted; however, there were 10 instances of mild hyperkalemia. Our data endorse the relative safety of using concentrated (200-mEq/L) potassium chloride infusions at a rate of 20 mEq/h via central or peripheral vein to correct hypokalemia in patients in the intensive care unit.

                Author and article information

                S. Karger AG
                October 2002
                18 October 2002
                : 92
                : Suppl 1
                : 28-32
                aDepartment of Internal Medicine, Hallym University Hangang Sacred Heart Hospital, and bDepartment of Internal Medicine, Seoul National University, Clinical Research Institute of Seoul National University Hospital, Seoul, Korea
                65374 Nephron 2002;92(suppl 1):28–32
                © 2002 S. Karger AG, Basel

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                Tables: 1, References: 28, Pages: 5
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/65374
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                Cardiovascular Medicine,Nephrology
                Cardiovascular Medicine, Nephrology
                Replacement, Hypokalemia, Treatment, Potassium


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