Dispelling myths and misconceptions about the treatment of acute hyperkalemia

被引：11

作者：

Gupta, Arnav A. ^{[1
]}

Self, Michael ^{[1
,2
]}

Mueller, Matthew ^{[1
,2
]}

Wardi, Gabriel ^{[1
,3
]}

Tainter, Christopher ^{[1
,2
]}

机构：

[1] Univ Calif San Diego, Dept Emergency Med, 201 W Arbor Dr, San Diego, CA 92013 USA

[2] Univ Calif San Diego, Dept Anesthesiol, Div Anesthesiol Crit Care Med, 201 W Arbor Dr, San Diego, CA 92013 USA

[3] Univ Calif San Diego, Dept Internal Med, Div Pulm Crit Care & Sleep Med, 201 W Arbor Dr, San Diego, CA 92013 USA

来源：

AMERICAN JOURNAL OF EMERGENCY MEDICINE | 2022年 / 52卷

基金：

美国国家卫生研究院;

关键词：

Hyperkalemia; Myths; Misconceptions; Treatment; lactated Ringer's; Calcium; EKG; ELECTROCARDIOGRAPHIC MANIFESTATIONS; BALANCED CRYSTALLOIDS; CALCIUM GLUCONATE; SERUM POTASSIUM; ACID-BASE; SALINE; MANAGEMENT; RESUSCITATION; IONIZATION; CONDUCTION;

D O I：

10.1016/j.ajem.2021.11.030

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Hyperkalemia represents a widespread and potentially lethal condition that affects millions of people across their lives. Despite the prevalence and severity of the condition, there are no consensus guidelines on the treatment of hyperkalemia or even a standard definition. Herein, we provide a succinct review of what we believe to be the most significant misconceptions encountered in the emergency care of hyperkalemia, examine current available literature, and discuss practical points on several modalities of hyperkalemia treatment. Additionally, we review the pathophysiology of the electrocardiographic effects of hyperkalemia and how intravenous calcium preparations can antagonize these effects. We conclude each section with recommendations to aid emergency physicians in making safe and efficacious choices for the treatment of acute hyperkalemia. (C) 2021 The Authors. Published by Elsevier Inc.

引用

页码：85 / 91

页数：7

共 70 条

[1] Hyperkalemia in hospitalized patients -: Causes, adequacy of treatment, and results of an attempt to improve physician compliance with published therapy guidelines [J].

Acker, CG ;

Johnson, JP ;

Palevsky, PM ;

Greenberg, A .

ARCHIVES OF INTERNAL MEDICINE, 1998, 158 (08) :917-924

[2] TRENDS IN EMERGENCY ROOM VISITS DUE TO HYPERKALEMIA IN THE UNITED STATES [J].

Aggarwal, S. ;

Topaloglu, H. ;

Kumar, S. .

VALUE IN HEALTH, 2015, 18 (07) :A386-A386

[3]

Alfonzo A, 2014, UK RENAL ASS, V147, P59

[4] Potassium disorders - clinical spectrum and emergency management [J].

Alfonzo, Annette V. M. ;

Isles, Chris ;

Geddes, Colin ;

Deighan, Chris .

RESUSCITATION, 2006, 70 (01) :10-25

[5]

[Anonymous], 2000, Circulation, V102, pI217

[6] Electrocardiography is unreliable in detecting potentially lethal hyperkalaemia in haemodialysis patients [J].

Aslam, S ;

Friedman, EA ;

Ifudu, O .

NEPHROLOGY DIALYSIS TRANSPLANTATION, 2002, 17 (09) :1639-1642

[7] Pharmacological interventions for the acute management of hyperkalaemia in adults [J].

Batterink, Josh ;

Cessford, Tara A. ;

Taylor, Robert A. I. .

COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2015, (10)

[8]

Batterink Josh, 2015, Can J Hosp Pharm, V68, P296

[9] The Cost of Hyperkalemia in the United States [J].

Betts, Keith A. ;

Woolley, J. Michael ;

Mu, Fan ;

Xiang, Cheryl ;

Tang, Wenxi ;

Wu, Eric Q. .

KIDNEY INTERNATIONAL REPORTS, 2018, 3 (02) :385-393

[10]

CHAMBERLAIN MJ, 1964, LANCET, V1, P464

← 1 2 3 4 5 6 7 →