Charat Thongprayoon1, Wisit Cheungpasitporn2, Api Chewcharat1, Michael A Mao3, Saraschandra Vallabhajosyula4, Tarun Bathini5, Sorkko Thirunavukkarasu1, Kianoush B Kashani1,6. 1. Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic , Rochester, MN, USA. 2. Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center , Jackson, MS, USA. 3. Division of Nephrology and Hypertension, Mayo Clinic , Jacksonville, FL, USA. 4. Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN, USA. 5. Department of Internal Medicine, University of Arizona , Tucson, AZ, USA. 6. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic , Rochester, MN, USA.
Abstract
BACKGROUND: The objective of this study was to assess the relationship between admission serum potassium and the risk of respiratory failure requiring mechanical ventilation in all hospitalized patients. METHODS: All non-dialysis and non-mechanically ventilated patients who had serum potassium measurement at admission from 2011 to 2013 were studied. Serum potassium levels were stratified into five groups; ≤3.4, 3.5 to 3.9, 4.0 to 4.4, 4.5 to 4.9, 5.0 to 5.4, and ≥5.5 mEq/L. The outcome of interest was the respiratory failure requiring mechanical ventilation during hospitalization. Logistic regression analysis was performed to assess the independent risk of in-hospital respiratory failure requiring mechanical ventilation based on various admission serum potassium, using serum potassium of 4.0 to 4.4 mEq/L as the reference group. RESULTS: Of 67,034 eligible patients, with the mean admission serum potassium of 4.2 ± 0.5 mEq/L, 2,886 (4.3%) patients developed respiratory failure requiring mechanical ventilation during hospitalization. As demonstrated by U-shaped association, increased risk of in-hospital respiratory failure was significantly associated with low admission serum potassium ≤ 3.4 mEq/L (odds ratio 1.36, p-value <0.001) and high admission serum potassium ≥5.5 mEq/L (odds ratio 1.37, p-value = 0.01). CONCLUSION: Increased risk of in-hospital respiratory failure requiring mechanical ventilation was noted when serum potassium was below 3.5 mEq/L or above 5.4 mEq/L at the time of hospital admission. Patients with either hypokalemia or hyperkalemia are at risk of respiratory failure requiring mechanical ventilation.
BACKGROUND: The objective of this study was to assess the relationship between admission serum potassium and the risk of respiratory failure requiring mechanical ventilation in all hospitalized patients. METHODS: All non-dialysis and non-mechanically ventilated patients who had serum potassium measurement at admission from 2011 to 2013 were studied. Serum potassium levels were stratified into five groups; ≤3.4, 3.5 to 3.9, 4.0 to 4.4, 4.5 to 4.9, 5.0 to 5.4, and ≥5.5 mEq/L. The outcome of interest was the respiratory failure requiring mechanical ventilation during hospitalization. Logistic regression analysis was performed to assess the independent risk of in-hospital respiratory failure requiring mechanical ventilation based on various admission serum potassium, using serum potassium of 4.0 to 4.4 mEq/L as the reference group. RESULTS: Of 67,034 eligible patients, with the mean admission serum potassium of 4.2 ± 0.5 mEq/L, 2,886 (4.3%) patients developed respiratory failure requiring mechanical ventilation during hospitalization. As demonstrated by U-shaped association, increased risk of in-hospital respiratory failure was significantly associated with low admission serum potassium ≤ 3.4 mEq/L (odds ratio 1.36, p-value <0.001) and high admission serum potassium ≥5.5 mEq/L (odds ratio 1.37, p-value = 0.01). CONCLUSION: Increased risk of in-hospital respiratory failure requiring mechanical ventilation was noted when serum potassium was below 3.5 mEq/L or above 5.4 mEq/L at the time of hospital admission. Patients with either hypokalemia or hyperkalemia are at risk of respiratory failure requiring mechanical ventilation.
Authors: Saraschandra Vallabhajosyula; Shiva P Ponamgi; Sanskriti Shrivastava; Pranathi R Sundaragiri; Virginia M Miller Journal: FASEB J Date: 2020-07 Impact factor: 5.191
Authors: Charat Thongprayoon; Michael A Mao; Andrea G Kattah; Mira T Keddis; Pattharawin Pattharanitima; Stephen B Erickson; John J Dillon; Vesna D Garovic; Wisit Cheungpasitporn Journal: Clin Kidney J Date: 2021-10-12
Authors: Charat Thongprayoon; Wisit Cheungpasitporn; Api Chewcharat; Michael A Mao; Kianoush B Kashani Journal: BMJ Open Date: 2020-03-23 Impact factor: 2.692