management of severe hyperkalemia

MANAGEMENT OF SEVERE HYPERKALEMIA

Management of severe hyperkalemia.

BACKGROUND AND OBJECTIVES Hyperkalemia is one of the few potentially lethal electrolyte disturbances. Prompt recognition and expeditious treatment of severe hyperkalemia are expected to save lives. This review is intended to provide intensivists and other interested clinicians with an understanding of the pathophysiology that underlies hyperkalemia, and a rational approach to its management. ...

Rhabdomyolysis-Induced Severe Hyperkalemia

A 22-year-old male was brought in by paramedics who found him unresponsive at home surrounded by drug paraphernalia. He had a blood pressure of 84/50 mm Hg; oxygen saturation of 88%; irregular pulse; and Glasgow Coma Scale of 3. His skin was cool, diaphoretic and ashen in color, except for a grossly erythematous right arm. Lab work demonstrated an initial creatine kinase of 5,414 U/L that incre...

Hyperkalemia and severe rhabdomyolysis

A 47-year-old homeless man with a history of bipolar disorder and polysubstance abuse was found under a bridge with altered mental status and severe left calf pain. Evaluation in the emergency department revealed a cachectic, pale man with a blood pressure of 132/84, pulse 74, and respirations 18. He was afebrile. Oxygen saturation was 98% on room air. Examination revealed marked swelling of th...

Severe hyperkalemia requiring hospitalization: predictors of mortality

INTRODUCTION Severe hyperkalemia, with potassium (K+) levels ≥ 6.5 mEq/L, is a potentially life-threatening electrolyte imbalance. For prompt and effective treatment, it is important to know its risk factors, clinical manifestations, and predictors of mortality. METHODS An observational cohort study was performed at 2 medical centers. A total of 923 consecutive Korean patients were analyzed. ...

Treatment of Severe Hyperkalemia: Confronting 4 Fallacies

Severe hyperkalemia is a medical emergency that can cause lethal arrhythmias. Successful management requires monitoring of the electrocardiogram and serum potassium concentrations, the prompt institution of therapies that work both synergistically and sequentially, and timely repeat dosing as necessary. It is of concern then that, based on questions about effectiveness and safety, many physicia...