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Electrolyte Disturbances - Potassium - Hyperkalemia

Q: First treatment of hyperkalemia with ECG abnormalities

Calcium chloride 10% 5-10 ml in 5-10 minutes (to stabilize myocardial cell membrane and decrease potential for arrhythmias) Effect only lasts 30-60 minutes > additional treatment

Q: Treatment of hyperkalemia (redistribution) (3)

Insuline and glucose (10 EH insuline with 50 g of 50% glucose over 5-10 min IV) > monitor glucose! Sodium bicarbonate (1 mmol/kg IV in 5-10 min) > less effective than 1. and in patients with end-stage renal failure Inhalation B2-agonist (salbutamol, 10-20 mg) > decrease of 0.5 mmol/L

Q: Treatment of hyperkalemia (removal) (3)

Increase urine output with loop diuretic (furo 1-2 mg/kg) and isotonic fluids Increase GI potassium loss with resonium or sorbitol (25-50 g) Initiate dialysis

3 important questions on Electrolyte Disturbances - Potassium - Hyperkalemia

First treatment of hyperkalemia with ECG abnormalities

Calcium chloride 10% 5-10 ml in 5-10 minutes (to stabilize myocardial cell membrane and decrease potential for arrhythmias)

Effect only lasts 30-60 minutes > additional treatment

Treatment of hyperkalemia (redistribution) (3)

Insuline and glucose (10 EH insuline with 50 g of 50% glucose over 5-10 min IV) > monitor glucose!
Sodium bicarbonate (1 mmol/kg IV in 5-10 min) > less effective than 1. and in patients with end-stage renal failure
Inhalation B2-agonist (salbutamol, 10-20 mg) > decrease of 0.5 mmol/L

Treatment of hyperkalemia (removal) (3)

Increase urine output with loop diuretic (furo 1-2 mg/kg) and isotonic fluids
Increase GI potassium loss with resonium or sorbitol (25-50 g)
Initiate dialysis