Comparison of IV Insulin Dosing Strategies for Hyperkalemia in the Emergency Department.
Comparison of IV Insulin Dosing Strategies for Hyperkalemia in the Emergency Department.
复制标题
急诊科高钾血症静脉注射胰岛素给药策略的比较。
DOI：
10.1097/cce.0000000000000092
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发表时间：
2020
影响因子：
--
通讯作者：
Fitter,Scott
中科院分区：
文献类型：
--
作者：
Moussavi,Kayvan;Nguyen,LaniT;Hua,Henry;Fitter,Scott
Objectives: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:Seven hundred adults treated for hyperkalemia with IV regular insulin between April 1, 2013, and September 27, 2018.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.
