Serum potassium levels as an outcome determinant in acute medical admissions

Conway, Richard; Creagh, Donnacha; Byrne, Declan; O’Riordan, Deirdre; Silke, Bernard

doi:10.7861/clinmedicine.15-3-239

Cited by 54 publications

(50 citation statements)

References 30 publications

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“…Hypernatraemia in present study was noted in 4% of the critically ill children. This finding is in consistent with the studies by Michael D. Waite et al, [14] Richard Conway et al [21] and Singhi et al [24] who observed hypokalaemia in 4.9% and 5.4% respectively, which were nearly comparable with our results.…”

Section: Discussionsupporting

confidence: 94%

“…In hypokalaemic group, mortality was estimated to be 1.2 times higher than normokalaemia consistent with results by Richard Conway et al, [21] Singhi et al [23] and Subba Rao et al [7] noted 27.7% mortality in hypokalaemic children.…”

Section: Mortalitysupporting

confidence: 87%

“…Hypokalaemia and hyperkalaemia in ICU has been observed at an incidence of 12% -15%. [7,[20][21][22][23][24] and 2% -6% [7,25,26] respectively. Potassium is necessary for the electrical responsiveness of nerve and muscle cells and for the contractility of cardiac, skeletal and smooth muscle.…”

Section: Introductionmentioning

confidence: 99%

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Electrolyte Disturbances in Critically Ill Children Admitted to Paediatric Tertiary Care Centre

Paidy¹,

Thapar²,

Gupta³

2017

jemds

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BACKGROUNDTo study the incidence, aetiology and length of ICU stay in children admitted to Paediatric Intensive Care Unit with electrolyte disturbances. MATERIALS AND METHODSDescriptive prospective study in children aged 1 month to 12 years. RESULTSIncidence of hyponatraemia (< 135 mEq/L) was 16.8%, hypernatraemia (> 145 mEq/L) 4%, hypokalaemia (< 3.5 mEq/L) 11.9% and hyperkalaemia (> 5.5 mEq/L) 2% respectively; 01 month -4 years age (41.2%) group of our study population emerged as a susceptible age group to electrolyte disturbances with mean age of 4.36 ± 4.10 yrs. Hyponatraemia occurred in 64.7% of boys, hypernatraemia occurred in 75% boys, hypokalaemia and hyperkalaemia in 50% boys. Spectrum of illness in hyponatraemia includes CNS disorders (52.9%), GI disorders (17.6%) and sepsis (11.8%). In hypernatraemia all four children were diagnosed to have CNS disorders. In hypokalaemia group CNS disorders, GI disorders, sepsis and renal disorders were responsible for 58.3%, 16.7%, 8.3% and 8.3% respectively. In hyperkalaemia group, CNS and GI disorders were responsible for 50% each. Mean Length of Stay (LOS) in hyponatraemia was 8.18 ± 7.65 days, hypernatraemia 10.50 ± 4.65 days, hypokalaemia 9.0 ± 8.56 days and hyperkalaemia 9.50 ± 7.78 days. Mortality was 1.9 times higher in children with hyponatraemia and 1.2 times higher in children with hypokalaemia compared to normal serum levels. CONCLUSIONDisturbances in the serum sodium and potassium levels during the ICU stay predicted an increased length of hospital stay. Early detection through regular monitoring and early correction may help in improving the outcome.

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Section: Discussionsupporting

confidence: 94%

Section: Mortalitysupporting

confidence: 87%

See 1 more Smart Citation

Electrolyte Disturbances in Critically Ill Children Admitted to Paediatric Tertiary Care Centre

Paidy¹,

Thapar²,

Gupta³

2017

jemds

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“…Hyperkalemia, usually defined as blood potassium level >5.0 mmol/L, is a concern in patients with HF in everyday clinical practice and can be a life‐threatening condition . Hyperkalemia with high potassium levels (eg, >6.0 mmol/L) may lead to cardiac arrhythmias and death, but even potassium levels of >5.0 mmol/L have been associated with increased mortality in patients with acute‐care hospital admission and in patients with HF …”

mentioning

confidence: 99%

Elevated Potassium Levels in Patients With Congestive Heart Failure: Occurrence, Risk Factors, and Clinical Outcomes

Thomsen

Nicolaisen

Hasvold³

et al. 2018

JAHA

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BackgroundData on the true burden of hyperkalemia in patients with heart failure (HF) in a real‐world setting are limited.Methods and ResultsIncidence rates of hyperkalemia (first blood test with a potassium level >5.0 mmol/L) in primary or hospital care were assessed in a population‐based cohort of patients with incident HF diagnoses in northern Denmark from 2000 to 2012. Risk factors and clinical outcomes were compared in patients with HF with versus without hyperkalemia. Of 31 649 patients with HF, 39% experienced hyperkalemia (mean follow‐up, 2.2 years). Risks of experiencing a second, third, or fourth event were 43%, 54%, and 60%, respectively. Among patients with HF with stage 3A, 3B, 4, or 5 kidney dysfunction, 26%, 35%, 44%, and 48% experienced hyperkalemia within the first year. Important hyperkalemia risk factors included chronic kidney disease (prevalence ratio, 1.46; 95% confidence interval [CI], 1.43−1.49), diabetes mellitus (prevalence ratio, 1.38; 95% CI, 1.32−1.45), and spironolactone use (prevalence ratio, 1.48; 95% CI, 1.42−1.54). In patients with HF who developed hyperkalemia, 53% had any acute‐care hospitalization 6 months before the hyperkalemia event, increasing to 74% 6 months after hyperkalemia (before‐after risk ratio, 1.41; 95% CI, 1.38−1.44). Compared with matched patients with HF without hyperkalemia, adjusted 6‐month hazard ratios in patients with hyperkalemia were 2.75‐fold (95% CI, 2.65–2.85) higher for acute‐care hospitalization and 3.39‐fold (95% CI, 3.19–3.61) higher for death.ConclusionsAlmost 4 in 10 patients with HF develop hyperkalemia, and many patients have recurrent hyperkalemia episodes. Hyperkalemia risk is strongly associated with degree of reduced kidney function and use of spironolactone. Hyperkalemia is associated with severe clinical outcomes and death in HF.

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“…A range for [K + ] in the cerebral spinal fluid for non-diseased state humans in one study was found to be 2.4-3.0 mmol/L and 3.5-4.70 mmol/L in plasma (Pye & Aber, 1982). A twofold increase in plasma [K + ] to 7 or 8 mmol/L in humans will likely lead to death, unless rapidly reduced (Conway, Creagh, Byrne, O'Riordan, & Silke, 2015;Gennari, 1998;Nyirenda, Tang, Padfield, & Seckl, 2009). A recent study measured the [K + ] in abscesses in the human brain and found the levels to have an average 10.6 ± 4.8 mmol/L (Dahlberg, Ivanovic, Mariussen, & Hassel, 2015).…”

Section: Discussionmentioning

confidence: 99%

The effects of potassium and muscle homogenate on proprioceptive responses in crayfish and crab

et al. 2017

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Proprioception of limbs and joints is a basic sensory function throughout most of the animal kingdom. It is important to understand how proprioceptive organs and the associated sensory neurons function with altered environments such as increased potassium ion concentrations ([K]) from diseased states, ionic imbalances, and damaged tissues. These factors can drastically alter neuronal activity. To assess this matter, we used the chordotonal organ in a walking leg of a blue crab (Callinectes sapidus) and the muscle receptor organ of the crayfish (Procambarus clarkii). These organs serve as tractable models for the analysis of proprioception. The preparations can help serve as translational models for these effects, which may be observed in other invertebrate species as well as mammalian species (including humans). When extracellular potassium concentration ([K]) is increased to 20 mM in both preparations, mixed results are observed with activity increasing in some preparations and decreasing in others after mechanical displacement. However, when [K] is increased to 40 mM, activity drastically decreases in all preparations. Additionally, proprioceptor sensory activity declines upon exposure to a diluted muscle homogenate, which contains a host of intracellular constituents. The robust effects of altered [K] on proprioception in these models illuminate the potential detriments on neuronal function in cases of severe tissue damage as well as altered [K].

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Serum potassium levels as an outcome determinant in acute medical admissions

Cited by 54 publications

References 30 publications

Electrolyte Disturbances in Critically Ill Children Admitted to Paediatric Tertiary Care Centre

Electrolyte Disturbances in Critically Ill Children Admitted to Paediatric Tertiary Care Centre

Elevated Potassium Levels in Patients With Congestive Heart Failure: Occurrence, Risk Factors, and Clinical Outcomes

The effects of potassium and muscle homogenate on proprioceptive responses in crayfish and crab

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