King Nicole, Martinson Neil, Lesudi Mmakwata, Variava Ebrahim
Department of Internal Medicine, University of the Witwatersrand, Johannesburg, and Klerksdorp Tshepong Hospital Complex, North West Department of Health, South Africa.
Perinatal HIV Research Unit (PHRU), Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, Johannesburg, South Africa.
SAGE Open Med Case Rep. 2025 Jun 18;13:2050313X251348368. doi: 10.1177/2050313X251348368. eCollection 2025.
Hyperkalaemia is a medical emergency that may manifest with a spectrum of cardiac conduction abnormalities and, if not promptly managed, can progress to cardiac arrest. While standard management typically involves stat doses of insulin to lower serum potassium, the optimal dosing regimen remains controversial. Patients whose serum potassium exceeds the upper normal limit by more than 1 mmol/L often require repeated conventional management to shift potassium intracellularly - usually every 2 to 4 h. Although dialysis is indicated in patients with concomitant renal dysfunction, its availability in resource-constrained settings is limited. We present three cases of symptomatic hyperkalaemia successfully managed with continuous insulin infusions, thereby obviating the need for dialysis. These cases underscore the potential role of continuous insulin infusions as an alternative strategy for correcting hyperkalaemia in settings where dialysis is not immediately available.
高钾血症是一种医疗急症，可能表现出一系列心脏传导异常，若不及时处理，可进展为心脏骤停。虽然标准治疗通常包括静脉注射胰岛素以降低血清钾水平，但最佳给药方案仍存在争议。血清钾超过正常上限1 mmol/L以上的患者通常需要反复进行传统治疗以促使钾进入细胞内，通常每2至4小时一次。虽然伴有肾功能不全的患者需要进行透析，但在资源有限的环境中，透析的可及性有限。我们报告了3例通过持续输注胰岛素成功治疗的症状性高钾血症病例，从而避免了透析的需要。这些病例强调了在无法立即进行透析的情况下，持续输注胰岛素作为纠正高钾血症的替代策略的潜在作用。
