Du Yu, Mou Yi, Liu Jin
Emergency Department and Intensive Care Unit, West China School of Public Health, No. 4 West China Teaching Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
Geroscience and Chronic Disease Department, The 8th Municipal People's Hospital, Chengdu, Sichuan 610083, P.R. China.
Exp Ther Med. 2019 Apr;17(4):3222-3232. doi: 10.3892/etm.2019.7292. Epub 2019 Feb 21.
Stringent regulations have been established for the intravenous administration of potassium to avoid hyperkalemia in the clinic. The standard approach, however, often does not work well for treating severe hypokalemia. In the present study, a rabbit model of hyperkalemia was used to develop an tailored rapid potassium supplementation strategy and the effectiveness and safety of this new strategy were assessed. A total of 20 rabbits with induced severe hypokalemia were randomly divided into two equal treatment groups. All of the animals were injected with 3% KCl through the auricular marginal veins by a micro-injection pump; the target serum potassium concentration was 4 mmol/l. The conventional treatment group was administered a continued potassium infusion at the standard infusion rate of 0.4 mmol/kg/h. The tailored rapid supplementation group was treated in two steps: First, a loading dose of potassium was rapidly injected for 5 min and this step was repeated until the serum potassium concentration was increased to 3.5 mmol/l. After this increase in serum potassium concentration, a sustained potassium infusion at a constant dose was performed. Electrocardiogram, blood pressure, respiratory rate, serum potassium concentration, urine volume and vital signs were monitored in real-time. No hyperkalemia occurred in any of the two the groups. However, compared with the conventional group, the tailored rapid group had a significantly shorter duration of potassium infusion and arrhythmia, and a higher survival rate. In conclusion, these results demonstrate that the tailored rapid potassium supplementation strategy shortened the time of hypokalemia and is a safe and better treatment option to remedy life-threatening arrhythmia caused by severe hypokalemia with a high success rate.
临床上已制定了严格的静脉补钾规定，以避免高钾血症。然而，标准方法在治疗严重低钾血症时往往效果不佳。在本研究中，使用高钾血症兔模型制定了一种量身定制的快速补钾策略，并评估了该新策略的有效性和安全性。将总共20只诱导产生严重低钾血症的兔子随机分为两个相等的治疗组。所有动物均通过微量注射泵经耳缘静脉注射3%氯化钾；目标血清钾浓度为4 mmol/l。传统治疗组以0.4 mmol/kg/h的标准输注速率持续输注钾。量身定制的快速补充组分两步治疗：首先，快速注射负荷剂量的钾5分钟，重复此步骤直至血清钾浓度升至3.5 mmol/l。血清钾浓度升高后，以恒定剂量持续输注钾。实时监测心电图、血压、呼吸频率、血清钾浓度、尿量和生命体征。两组均未发生高钾血症。然而，与传统组相比，量身定制的快速组钾输注持续时间和心律失常时间明显缩短，存活率更高。总之，这些结果表明，量身定制的快速补钾策略缩短了低钾血症的时间，是一种安全且更好的治疗选择，可成功治疗由严重低钾血症引起的危及生命的心律失常。
