In Response to “In Reference to: ‘Preventing Hypoglycemia Following Treatment of Hyperkalemia in Hospitalized Patients‘”

Wearable biosensors′ ability to measure continuous health parameters gives promise to healthcare with great potentials to advance precision medicine. The stability and balance within the human body are critical for organ systems′ normal functions. The imbalance of electrolytes may lead to several diseases such as hypertension, heart failure, and kidney diseases. Sweat electrolytes analysis, that is, the analysis of one of the noninvasively accessible biofluids, can provide important information about physiologically relevant quantities, and a combination of them can be employed for comprehensive studies. However, wearable biosensors′ large‐scale utilization for extensive population monitoring requires rapid, reliable, low‐cost, and high‐throughput integration of such platforms. Here, 3D‐printing technology is adapted to develop a novel, multiplex, low‐cost, and mechanically flexible all‐inclusive integrated wearable (AIIW) patch, which contains 3D‐printed flexible sensors along with flexible wearable‐microfluidic sample handling (WMFSH) units, integrated in a few hours. The AIIW patch is fully characterized, and its utility for noninvasive and continuous health monitoring is successfully demonstrated by simultaneous ex situ and in situ measuring of multiple electrolyte levels in sweat. This work is envisioned as another step toward enabling personalized health monitoring practices by implementing 3D‐printing technology in the easy and low‐cost development of customized integrated, flexible wearable biosensing platforms to monitor an individual's health parameters.

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A 3D Printed Wearable Bioelectronic Patch for Multi‐Sensing and In Situ Sweat Electrolyte Monitoring

Kim

Qian

Hoang

et al. 2021

Adv Materials Technologies

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Kreislaufstillstand unter besonderen Umständen

Lott

Truhlář

Alfonzo

et al. 2021

Notfall Rettungsmed

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Diese Leitlinien des European Resuscitation Council (ERC) für den Kreislaufstillstand unter besonderen Umständen basieren auf dem 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. Dieses Kapitel enthält Leitlinien zu den Modifikationen der lebensrettenden Basismaßnahmen und erweiterten lebensrettenden Maßnahmen zur Vorbeugung und Behandlung von Kreislaufstillständen unter besonderen Umständen; insbesondere spezielle Ursachen (Hypoxie, Trauma, Anaphylaxie, Sepsis, Hypo‑/Hyperkaliämie und andere Elektrolytstörungen, Hypothermie, Lawinengeschehen, Hyperthermie und maligne Hyperthermie, Lungenembolie, Koronarthrombose, Herzbeuteltamponade, Spannungspneumothorax, Giftstoffe), spezielle Umstände (Operationssaal, Herzchirurgie, Herzkatheterlabor, Dialyseeinheit, Zahnkliniken, Transport während des Flugs, Kreuzfahrtschiffe, Sport, Ertrinken, Großschadensereignisse) und spezielle Patientengruppen (Asthma und chronisch obstruktive Lungenerkrankung, neurologische Erkrankungen, krankhafte Adipositas, Schwangerschaft). Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s10049-021-00891-z) enthält das originale Zusatzmaterial aus dem Artikel in Resuscitation. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

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Clinical outcomes associated with the emergency treatment of hyperkalaemia with intravenous insulin-dextrose

Humphrey

James

Wilkinson

et al. 2022

European Journal of Internal Medicine

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Background: Hyperkalaemia occurs in up to 10% of hospital admissions but its treatment in the emergency setting is inconsistent. Objectives: To describe the emergency management of hyperkalaemia in adults with insulin-dextrose (IDex) and to explore clinical outcomes associated with IDex treatment. Design and setting: Cohort study using comprehensive electronic health records of all emergency admissions to a large university hospital in the United Kingdom between April 2015 and August 2018. Participants: Adult patients aged ≥16 years with at least one emergency admission and one blood potassium result during the study period. Main outcomes and measures: Emergency hyperkalaemia treatment was evaluated including the requirement for re-treatment with IDex, episodes of glucose dysregulation, intensive care (ICU) admission and length of hospital stay. Associations with hyperkalaemia, adverse events and IDex treatment were explored by logistic regression. Results: Amongst 211,993 patients attending the Emergency Department (ED) we identified 11,107 hyperkalaemic adult patients, of whom 1,284 were treated with IDex. Multiple doses were required in 542 patients (42.2%). Hypoglycaemia (plasma glucose < 4 mmol/L) occurred in 249 patients (19.4%) within 6 hours of IDex. Repeated doses were associated with an increased risk of hypoglycaemia (OR 2.94, 95% CI 2.20 to 3.93) compared to patients receiving a single dose, which, after adjustment was also associated with an increased risk of death (OR 1.56, 95% CI 1.16 to 2.09) during the study period. Patients who received multiple doses of IDex (OR 2.2, 95% CI 1.6-3.1) and those who received a dose of insulin above the guideline recommended limit (OR 5.6 3.1-10.3) were more likely to be admitted to ICU following IDex than those who received a single dose or the guideline recommended dose of insulin. Conclusions and Relevance:This study provides novel insight into the emergency management of hyperkalaemia in a large population, demonstrates the high risk of hypoglycaemia and highlights the urgent need for an improved, evidence-based approach to the emergency management of hyperkalaemia.

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In Response to “In Reference to: ‘Preventing Hypoglycemia Following Treatment of Hyperkalemia in Hospitalized Patients‘”

Cited by 6 publications

References 7 publications

A 3D Printed Wearable Bioelectronic Patch for Multi‐Sensing and In Situ Sweat Electrolyte Monitoring

A 3D Printed Wearable Bioelectronic Patch for Multi‐Sensing and In Situ Sweat Electrolyte Monitoring

Kreislaufstillstand unter besonderen Umständen

Clinical outcomes associated with the emergency treatment of hyperkalaemia with intravenous insulin-dextrose

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