Brian M Cummings1, Eric A Macklin2, Phoebe H Yager1, Amita Sharma3, Natan Noviski4. 1. Division of Pediatric Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA. 2. Massachusetts General Hospital Biostatistics Center, Boston, MA, USA. 3. Division of Pediatrics Nephrology, Yawkey Center for Outpatient Care (MGH), Boston, MA, USA. 4. Division of Pediatric Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA nnoviski@partners.org.
Abstract
BACKGROUND: Potassium abnormalities are common in critically ill patients. We describe the spectrum of potassium abnormalities in our tertiary-level pediatric intensive care unit (PICU). METHODS: Retrospective observational cohort of all the patients admitted to a single-center tertiary PICU over a 1-year period. Medical records and laboratory results were obtained through a central electronic data repository. RESULTS: A total of 512 patients had a potassium measurement. Of a total of 4484 potassium measurements, one-third had abnormal values. Hypokalemia affected 40% of the admissions. Mild hypokalemia (3-3.4 mmol/L) affected 24% of the admissions. Moderate or severe hypokalemia (K <3.0 mmol/L) affected 16% of the admissions. Hyperkalemia affected 29% of the admissions. Mild hyperkalemia (5.1-6.0 mmol/L) affected 17% of the admissions. Moderate or severe hyperkalemia (>6.0 mmol/L) affected 12%. Hemolysis affected 2% of all the samples and 24% of hyperkalemic values. On univariate analysis, severity of hypokalemia was associated with mortality (odds ratio 2.2, P = .003). CONCLUSIONS: Mild potassium abnormalities are common in the PICU. Repeating hemolyzed hyperkalemic samples may be beneficial. Guidance in monitoring frequencies of potassium abnormalities in pediatric critical care is needed.
BACKGROUND:Potassium abnormalities are common in critically illpatients. We describe the spectrum of potassium abnormalities in our tertiary-level pediatric intensive care unit (PICU). METHODS: Retrospective observational cohort of all the patients admitted to a single-center tertiary PICU over a 1-year period. Medical records and laboratory results were obtained through a central electronic data repository. RESULTS: A total of 512 patients had a potassium measurement. Of a total of 4484 potassium measurements, one-third had abnormal values. Hypokalemia affected 40% of the admissions. Mild hypokalemia (3-3.4 mmol/L) affected 24% of the admissions. Moderate or severe hypokalemia (K <3.0 mmol/L) affected 16% of the admissions. Hyperkalemia affected 29% of the admissions. Mild hyperkalemia (5.1-6.0 mmol/L) affected 17% of the admissions. Moderate or severe hyperkalemia (>6.0 mmol/L) affected 12%. Hemolysis affected 2% of all the samples and 24% of hyperkalemic values. On univariate analysis, severity of hypokalemia was associated with mortality (odds ratio 2.2, P = .003). CONCLUSIONS: Mild potassium abnormalities are common in the PICU. Repeating hemolyzed hyperkalemic samples may be beneficial. Guidance in monitoring frequencies of potassium abnormalities in pediatric critical care is needed.
Authors: Murray M Pollack; James M Chamberlain; Anita K Patel; Julia A Heneghan; Eduardo A Trujillo Rivera; Dongkyu Kim; James E Bost Journal: Pediatr Crit Care Med Date: 2021-02-01 Impact factor: 3.971
Authors: Carolt Arana Aliaga; Leonor Fayos de Arizon; Rosario Montañés Bermúdez; Jose A Ballarín Castán; Anna Vila Santandreu Journal: J Bras Nefrol Date: 2019-05-30