Abstract |
The objectives of this study were to evaluate the safety and efficacy of insulin dosing of less than 10 units versus 10 units in patients receiving hyperkalemia treatment. DESIGN: Retrospective single-center study. SETTING: Emergency department at a large academic medical center in the United States. PATIENTS: INTERVENTIONS: Patients that received less than 10 units of insulin were compared to those that received 10 units of insulin. MEASUREMENTS AND MAIN RESULTS: Patients treated with less than 10 units had significantly lower frequency of hypoglycemia (11.2% vs 17.6%; p = 0.008). Reduction in serum potassium was significantly more modest in size in patients treated with less than 10 units (mean reduction 0.94 ± 0.71 mMol/L) compared with patients treated with 10 units (mean reduction 1.11 ± 0.8 mMol/L; p = 0.008). There were no statistically significant differences between groups in time to hypoglycemia, nadir serum glucose, severe hypoglycemia (<40 mg/dL), dextrose requirements, use of concurrent agents for hyperkalemia, need for repeat insulin dosing, length of stay, or mortality. CONCLUSIONS: Patients treated for hyperkalemia with insulin doses less than 10 units had reduced frequency of hypoglycemia; however, potassium reduction post treatment was more modest in these patients. These findings suggest providers choosing to administer 10 units IV insulin should ensure patients have adequate monitoring for hypoglycemia.
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Authors | Kayvan Moussavi, Lani T Nguyen, Henry Hua, Scott Fitter |
Journal | Critical care explorations
(Crit Care Explor)
Vol. 2
Issue 4
Pg. e0092
(Apr 2020)
ISSN: 2639-8028 [Electronic] United States |
PMID | 32426734
(Publication Type: Journal Article)
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Copyright | Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. |