Abstract | BACKGROUND: OBJECTIVE: To determine whether modifications to a potassium cocktail formulation, based on a prior quality improvement project, resulted in a decrease in the incidence of hyperglycemia and acidosis associated with its use, and to evaluate the effectiveness of the k-cocktail in lowering serum potassium levels and the incidence of adverse effects. METHODS: We conducted a retrospective cohort study of neonates with hyper-kalemia who received 2 k-cocktail formulations (group 1 [n = 13], original formulation, dextrose: insulin 5:1; group 2 [n = 26], modified formulation, dextrose: insulin 3.3:1). Group 2 subjects were matched 2:1 by gestational age and birth weight with those in group 1. Variables related to safety and effectiveness of therapy were assessed by medical record review. The following tests were used to assess group differences: χ(2), Fisher exact, 2-tailed t-tests, and mixed linear models. RESULTS: The incidence of hyperglycemia during the modified k-cocktail infusion in group 2 decreased from 76.9% to 21.7% (p = 0.001). Serum blood glucose concentrations increased during the infusion, on average, for group 1 infants and were unchanged during the infusion for those in group 2. The incidence of acidosis during the infusion was similar between groups (group 1 [76.9%] vs group 2 [68.2%]; p = 0.58). No significant adverse events were observed. Serum potassium concentrations decreased similarly in both groups. CONCLUSIONS:
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Authors | Alexandra Oschman, Amanda Gansen, Howard Kilbride, Tracy Sandritter |
Journal | The Annals of pharmacotherapy
(Ann Pharmacother)
Vol. 45
Issue 11
Pg. 1371-7
(Nov 2011)
ISSN: 1542-6270 [Electronic] United States |
PMID | 22009997
(Publication Type: Journal Article)
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Chemical References |
- Blood Glucose
- Insulin
- Potassium Compounds
- Glucose
- Calcium Gluconate
- Sodium Lactate
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Topics |
- Acidosis
(blood, drug therapy, prevention & control)
- Blood Glucose
(metabolism)
- Calcium Gluconate
(administration & dosage)
- Cohort Studies
- Drug Therapy, Combination
(methods)
- Glucose
(administration & dosage)
- Humans
- Hyperglycemia
(blood, drug therapy, prevention & control)
- Hyperkalemia
(blood, complications, drug therapy)
- Infant
- Infusions, Intravenous
- Insulin
(administration & dosage)
- Medical Records
- Potassium Compounds
(administration & dosage)
- Retrospective Studies
- Sodium Lactate
(administration & dosage)
- Treatment Outcome
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