Hootkins Robert, Emmett Michael
Division of Nephrology, Department of Internal Medicine, Baylor University Medical CenterDallasTexas.
Proc (Bayl Univ Med Cent). 2019 Oct 17;33(1):24-27. doi: 10.1080/08998280.2019.1678339. eCollection 2020 Jan.
This study examined the safety and efficacy of the intravenous administration of 20 mEq potassium chloride (KCl) dissolved in a 100 cc 5% dextrose in sterile water bolus over 1 hour through a subclavian central vein catheter in critical care unit patients for the treatment of low and low to normal serum potassium concentrations. We studied seven patients with morning serum potassium between 2.4 and 3.6 mEq/L who had intravenous KCl boluses ordered by their treating physician. Intracardiac and peripheral venous potassium levels were obtained before, during, and after infusion. Holter and electrocardiogram assessment of rhythm, supraventricular and ventricular ectopy, and electrical intervals were recorded before, during, and after the intravenous KCl bolus. The cardiac rhythm, heart rates, and electrocardiographic intervals remained unchanged throughout the infusion and postinfusion phases. In six of the seven patients, there was no new or worsening supraventricular or ventricular ectopy temporally related to the infusion. Postinfusion potassium levels increased in all patients, with an average peripheral vein serum potassium increase of 0.4 mEq/L. In conclusion, within the limitations of our sample size, our study demonstrated the safety and efficacy of the central venous infusion of 20 mEq KCl in 100 cc 5% dextrose in sterile water administered over 1 hour.
本研究探讨了在重症监护病房患者中，通过锁骨下中心静脉导管，在1小时内静脉推注溶解于100 cc无菌水中的20 mEq氯化钾（KCl）加5%葡萄糖，用于治疗低血钾以及血钾浓度处于低至正常范围的安全性和有效性。我们研究了7例早晨血清钾浓度在2.4至3.6 mEq/L之间且经主治医生医嘱静脉推注氯化钾的患者。在输注前、输注期间和输注后获取心内和外周静脉血钾水平。在静脉推注氯化钾前、期间和之后记录动态心电图及心电图对心律、室上性和室性异位心律以及电间期的评估。在整个输注期和输注后阶段，心律、心率和心电图间期均保持不变。7例患者中有6例未出现与输注时间相关的新发或加重的室上性或室性异位心律。所有患者输注后血钾水平均升高，外周静脉血清钾平均升高0.4 mEq/L。总之，在我们样本量的限制范围内，我们的研究证明了在1小时内通过中心静脉输注100 cc无菌水中溶解的20 mEq KCl加5%葡萄糖的安全性和有效性。
