DeCarolis Douglas D, Kim Grace Miran, Rector Thomas S, Ishani Areef
Minneapolis VA Health Care System, University of Minnesota Medical School Pharmacy, University of Minnesota College of Pharmacy, USA.
University of Washington Medicine-Valley Medical Center, USA.
Intensive Crit Care Nurs. 2016 Oct;36:17-23. doi: 10.1016/j.iccn.2015.08.005. Epub 2016 Feb 9.
To compare the change in potassium concentration (dose-response) using the intravenous versus enteral route for potassium replenishment.
RESEARCH METHODOLOGY/DESIGN: Cross-sectional analysis of individual potassium chloride doses with resulting changes in plasma potassium concentrations in intensive care patients. Potassium chloride was administered according to potassium replenishment protocols. For inclusion, doses were required to have pre- and post-dose plasma potassium concentrations obtained within 8hours of administration.
Medical and surgical intensive care units of a United States Veterans Affairs Medical Center.
The primary outcome was the dose-response slope for intravenous versus enteral potassium administration as estimated by linear regression analysis. Multivariable linear regression was employed to adjust for potential confounders.
The sample had 278 potassium chloride doses administered to 142 patients. The potassium concentration change per 20mmol of potassium chloride was similar for intravenous and enteral routes, 0.25mmol/L (95% confidence interval 0.16-0.33) versus 0.27mmol/L (0.15-0.39) respectively (p=0.73). Multivariable linear regression did not alter results. The success of achieving a minimum potassium concentration defined by the specific protocol was similar for intravenous (61%) and enteral (59%) administration. Overall, 77% of potassium chloride doses were administered at a time when patients were eligible to receive an enteral dosage form.
The enteral route was as effective as the intravenous route in increasing the plasma potassium concentration. The enteral route was widely available for potassium replenishment. Despite enteral route availability and the well-known reliability of potassium chloride absorption, the majority of doses were administered intravenously.
比较静脉途径与肠内途径补钾时钾浓度的变化（剂量反应）。
研究方法/设计：对重症监护患者个体氯化钾剂量及其导致的血浆钾浓度变化进行横断面分析。氯化钾根据补钾方案给药。纳入标准为给药后8小时内获得给药前和给药后的血浆钾浓度。
美国退伍军人事务医疗中心的内科和外科重症监护病房。
主要观察指标是通过线性回归分析估计的静脉和肠内补钾的剂量反应斜率。采用多变量线性回归对潜在混杂因素进行校正。
样本中有278剂氯化钾给予了142名患者。静脉和肠内途径每20mmol氯化钾的钾浓度变化相似，分别为0.25mmol/L（95%置信区间0.16 - 0.33）和0.27mmol/L（0.15 - 0.39）（p = 0.73）。多变量线性回归未改变结果。静脉给药（61%）和肠内给药（59%）达到特定方案定义的最低钾浓度的成功率相似。总体而言，77%的氯化钾剂量是在患者有资格接受肠内剂型时给予的。
肠内途径在提高血浆钾浓度方面与静脉途径同样有效。肠内途径广泛可用于补钾。尽管肠内途径可用且氯化钾吸收的可靠性众所周知，但大多数剂量是通过静脉给药的。
