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THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT

Year 2003, Volume: 16 Issue: 1, 32 - 35, 03.12.2016

Abstract

Objective: Hypokalemia, a frequent electrolyte imbalance encountered In the Intensive Care Unit (ICU), is an important cause of morbidity and mortality in critically ill patients. In this study the etiology and incidence of hypokalemia in critically ill patients was investigated retrospectively.
Methods: The ICU records of 440 patients, followed up more than 2 days in surgical intensive care and reanimation unit between 01.01.1999 and 31.12.2000 were analysed retrospectively. When hypokalemia was first observed (K<3.5 meq/L) in patients, the coexisting pathologies such as hypothermia (axillary body temperature <36°C), dialysis, presence of diarrhea, vomiting and ketoacidosis, arterial pH values, type of nutrition, use of insulin, diuretics and beta adrenergic agents, presence of blood transfusions were recorded. The relationship between these data, age, type of surgery and hypokalemia was recorded. The data obtained were compared statistically with ANOVA, Fisher’s exact and Chi-square tests (p<0.05).
Results: In 192 of 440 patients (40%) hypokalemia was found for the first time on 2.3±1.3th day of their ICU stay. The incidence of hypokalemia concerning the type of surgery was found as 59% in radical cystectomies, 51% in
vascular craniotomies, 50% in radical prostatectomies and 47% in tumoral craniotomies. The relationship between hypokalemia and clinical findings, and the medications used are found significant (p<0.05). In the presence of metabolic alkalosis, the incidence of hypokalemia was 76%. Hypokalemia incidence in patients receiving enteral or parenteral nutrition was twice that of patients receiving oral nutrition.
Conclusion: Causes and incidence of
hypokalemia must be established and follow up of plasma potassium levels should be done frequently in critically ill patients in the high risk group. This will decrease the mortality and morbidity with early replacement therapy.
Key words: Electrolyte imbalance,
Hypokalemia, Intensive Care Unit.

References

  • Frederic SB, Darryl YS. Critical care diagnosis and treatment. First Edition. Philadelphia, USA: Appleton&Lange, 1994: 313.
  • Marino PL. The ICU Book. Second Edition.
  • Pennsylvania USA: Williams and Wilkins,
  • : 650.
  • Shorr AF. An update on cost-effectiveness analysis in critical care. Curr Opin Crit Care 2002; 8: 337-343.
  • Rastergar A, Soleimani M. Hypokalemia and hyperkalemia. Postrgrad Med J 2001 ; 77: 759- 771.
  • Brown MJ, Brown DC, Murphy MB. Hypokalemia from beta-2 receptor stimulation by circulating epinephrine. H Engl Med 1983; 309: 1414-1419.
  • Androgue HJ, Madias HE. Changes in plasma potassium concentration during acute acid- base disturbances. Am J Med 1981 ;71:456- 467.
  • Dubose TD Jr. Hyperkalemic hyperchloremic metabolic acidosis: pathophysiologic insight. Kidney int 1997; 51: 591-602.
  • Gennari FJ. Hypokalemia. H Engl Med 1998; 339: 451-457.
  • Salem M, Munoz R, Chernow B. Hypomagnesemia in critical illness. Crit Care Clin 1991; 7: 225-252.
  • Wongsuravat H, David B, Morley J. Thermoregulatory failure in the elderly. J Am Geriatr Soc 1990; 38: 900-906.
  • Oh MS, Carroll HJ. Cerebral salt-wasting syndrome: We need better proof of its existence. nephron 1999; 82: 110-119.
  • Fernandez RE, Martinez MM, Opava SS. Role of water balance in the enhanced potassium excretion and hypokalemia of rats with diabetes insipidus. J Physiol 1980; 305: 97- 108.
  • Fukui S, Otani H, Katoh H, et al. Female gender as a risk factor for hypokalemia and QT prolongation after subarachnoid
Year 2003, Volume: 16 Issue: 1, 32 - 35, 03.12.2016

Abstract

References

  • Frederic SB, Darryl YS. Critical care diagnosis and treatment. First Edition. Philadelphia, USA: Appleton&Lange, 1994: 313.
  • Marino PL. The ICU Book. Second Edition.
  • Pennsylvania USA: Williams and Wilkins,
  • : 650.
  • Shorr AF. An update on cost-effectiveness analysis in critical care. Curr Opin Crit Care 2002; 8: 337-343.
  • Rastergar A, Soleimani M. Hypokalemia and hyperkalemia. Postrgrad Med J 2001 ; 77: 759- 771.
  • Brown MJ, Brown DC, Murphy MB. Hypokalemia from beta-2 receptor stimulation by circulating epinephrine. H Engl Med 1983; 309: 1414-1419.
  • Androgue HJ, Madias HE. Changes in plasma potassium concentration during acute acid- base disturbances. Am J Med 1981 ;71:456- 467.
  • Dubose TD Jr. Hyperkalemic hyperchloremic metabolic acidosis: pathophysiologic insight. Kidney int 1997; 51: 591-602.
  • Gennari FJ. Hypokalemia. H Engl Med 1998; 339: 451-457.
  • Salem M, Munoz R, Chernow B. Hypomagnesemia in critical illness. Crit Care Clin 1991; 7: 225-252.
  • Wongsuravat H, David B, Morley J. Thermoregulatory failure in the elderly. J Am Geriatr Soc 1990; 38: 900-906.
  • Oh MS, Carroll HJ. Cerebral salt-wasting syndrome: We need better proof of its existence. nephron 1999; 82: 110-119.
  • Fernandez RE, Martinez MM, Opava SS. Role of water balance in the enhanced potassium excretion and hypokalemia of rats with diabetes insipidus. J Physiol 1980; 305: 97- 108.
  • Fukui S, Otani H, Katoh H, et al. Female gender as a risk factor for hypokalemia and QT prolongation after subarachnoid
There are 15 citations in total.

Details

Journal Section Original Research
Authors

Arzu Gerçek This is me

Tümay Umuroğlu This is me

Feyza İnci This is me

Yılmaz Göğüs This is me

Publication Date December 3, 2016
Published in Issue Year 2003 Volume: 16 Issue: 1

Cite

APA Gerçek, A., Umuroğlu, T., İnci, F., Göğüs, Y. (2016). THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT. Marmara Medical Journal, 16(1), 32-35.
AMA Gerçek A, Umuroğlu T, İnci F, Göğüs Y. THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT. Marmara Med J. March 2016;16(1):32-35.
Chicago Gerçek, Arzu, Tümay Umuroğlu, Feyza İnci, and Yılmaz Göğüs. “THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT”. Marmara Medical Journal 16, no. 1 (March 2016): 32-35.
EndNote Gerçek A, Umuroğlu T, İnci F, Göğüs Y (March 1, 2016) THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT. Marmara Medical Journal 16 1 32–35.
IEEE A. Gerçek, T. Umuroğlu, F. İnci, and Y. Göğüs, “THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT”, Marmara Med J, vol. 16, no. 1, pp. 32–35, 2016.
ISNAD Gerçek, Arzu et al. “THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT”. Marmara Medical Journal 16/1 (March 2016), 32-35.
JAMA Gerçek A, Umuroğlu T, İnci F, Göğüs Y. THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT. Marmara Med J. 2016;16:32–35.
MLA Gerçek, Arzu et al. “THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT”. Marmara Medical Journal, vol. 16, no. 1, 2016, pp. 32-35.
Vancouver Gerçek A, Umuroğlu T, İnci F, Göğüs Y. THE ETIOLOGY AND INCIDENCE OF HYPOKALEMIA IN INTENSIVE CARE UNIT. Marmara Med J. 2016;16(1):32-5.