Rafique Zubaid, Kosiborod Mikhail, Clark Carol L, Singer Adam J, Turner Stewart, Miller Joseph, Char Douglas, Peacock W Frank
Ben Taub General Hospital, Baylor College of Medicine, Houston, TX, USA.
Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO, USA.
Clin Exp Emerg Med. 2017 Sep 30;4(3):154-159. doi: 10.15441/ceem.17.207. eCollection 2017 Sep.
Hyperkalemia affects up to 10% of hospitalized patients and, if left untreated, can lead to serious cardiac arrhythmias or death. Although hyperkalemia is frequently encountered in the emergency department (ED), and is potentially life-threatening, standard of care for the treatment is poorly defined, with little supporting evidence. The main objectives of this observational study are to define the overall burden of hyperkalemia in the ED setting, describe its causes, the variability in treatment patterns and characterize the effectiveness and safety of ED standard of care therapies used in the United States.
This is an observational study evaluating the management of hyperkalemia in the ED. Two hundred and three patients who presented to the ED with a potassium value ≥5.5 mmol/L were enrolled in the study at 14 sites across the United States. Patients were treated per standard of care practices at the discretion of the patient's physician. In patients who received a treatment for hyperkalemia, blood samples were drawn at pre-specified time points and serum potassium values were recorded. The change in potassium over 4 hours and the adverse events after standard of care treatment were analyzed.
This article describes the background, rationale, study design, and methodology of the REVEAL-ED (Real World Evidence for Treatment of Hyperkalemia in the Emergency Department) trial, a multicenter, prospective, observational study evaluating contemporary management of patients admitted to the ED with hyperkalemia.
高钾血症影响高达10%的住院患者，若不治疗可导致严重心律失常或死亡。尽管高钾血症在急诊科（ED）很常见且有潜在生命危险，但治疗的护理标准定义不明确，支持证据很少。这项观察性研究的主要目的是确定急诊科环境中高钾血症的总体负担，描述其病因、治疗模式的变异性，并描述美国使用的急诊科护理标准疗法的有效性和安全性。
这是一项评估急诊科高钾血症管理的观察性研究。在美国14个地点，203名血钾值≥5.5 mmol/L并前往急诊科就诊的患者被纳入研究。患者由其医生自行决定按照护理标准进行治疗。对于接受高钾血症治疗的患者，在预先指定的时间点采集血样并记录血清钾值。分析4小时内血钾的变化以及护理标准治疗后的不良事件。
本文描述了REVEAL-ED（急诊科高钾血症治疗的真实世界证据）试验的背景、基本原理、研究设计和方法，这是一项多中心、前瞻性、观察性研究，评估急诊科收治的高钾血症患者的当代管理情况。
