Emergency Center, Jesse Brown Veteran Affairs Medical Center, Chicago, Illinois 60612, USA.
J Hosp Med. 2011 Mar;6(3):136-40. doi: 10.1002/jhm.834.
Limited data exist on the precise dose of sodium polystyrene sulfonate (SPS) needed for specific potassium concentrations in the management of mild to moderate hyperkalemia in an inpatient hospital setting.
A retrospective cohort study involving a review of electronic medical records of inpatients receiving SPS for the treatment of hyperkalemia was conducted at the Jesse Brown Veteran Affairs Medical Center, between January 1, 2006 and December 31, 2006. Hyperkalemia was defined as a serum potassium concentration >5.1 mmol/L. The primary endpoint was the mean change in potassium concentration associated with specific SPS dosage administration.
A total of 122 patients were selected for inclusion in the analysis. The mean potassium concentrations before SPS administration were 5.40 ± 0.18 mmol/L, 5.51 ± 0.30, 5.83 ± 0.46, and 5.92 ± 0.30 in the 15, 30, 45, and 60 gm groups, respectively. The mean potassium concentration decreased by 0.82 ± 0.48 mmol/L in the 15 gm group, 0.95 ± 0.47 in the 30 gm group, 1.11 ± 0.58 in the 45 gm group, and 1.40 ± 0.42 in the 60 gm group. After a single dose of SPS, the mean potassium concentration was within normal range in 115 patients (94%).
A possible direct dose response relationship between SPS and the reduction in serum potassium concentration was found and should be evaluated prospectively.
在住院环境中，对于轻度至中度高钾血症的治疗，关于特定钾浓度下所需的聚苯乙烯磺酸钠（SPS）的确切剂量，仅有有限的数据。
这是一项回顾性队列研究，研究人员对杰西布朗退伍军人事务医疗中心 2006 年 1 月 1 日至 2006 年 12 月 31 日期间接受 SPS 治疗高钾血症的住院患者的电子病历进行了审查。高钾血症定义为血清钾浓度>5.1mmol/L。主要终点是与特定 SPS 剂量给药相关的钾浓度的平均变化。
共选择了 122 名患者进行分析。SPS 给药前的平均血钾浓度分别为 15、30、45 和 60 gm 组中的 5.40±0.18mmol/L、5.51±0.30mmol/L、5.83±0.46mmol/L 和 5.92±0.30mmol/L。15gm 组的平均血钾浓度降低了 0.82±0.48mmol/L，30gm 组降低了 0.95±0.47mmol/L，45gm 组降低了 1.11±0.58mmol/L，60gm 组降低了 1.40±0.42mmol/L。单次 SPS 给药后，115 名患者（94%）的平均血钾浓度恢复正常范围。
发现 SPS 与血清钾浓度降低之间可能存在直接的剂量反应关系，应进行前瞻性评估。
