Reducing the harm associated in treating hyperkalaemia with insulin and dextrose.

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Clinical Medicine Pub Date : 2024-07-01 Epub Date: 2024-06-12 DOI:10.1016/j.clinme.2024.100222
Sara Abou Sherif, Irene Katsaiti, Hannah Jebb, Serena Banh, Rachna Bedi, Jeremy Levy, David Thomas, Damien Ashby, Richard Corbett
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Abstract

Inpatient treatment of hyperkalaemia with insulin and dextrose can be complicated by iatrogenic hypoglycaemia. We sought to assess the incidence of hypoglycaemia in hospitalised patients with renal disease and assess the impact of the introduction of a local guideline incorporating the use of sodium zirconium cyclosilicate (SZC) for patients with moderate hyperkalaemia. After establishing a significant burden of hypoglycaemia in the initial observation period, a requirement for hourly capillary blood glucose monitoring (for up to 6 h) following the administration of insulin for hyperkalaemia was incorporated into the guidelines. The two-fold introduction of SZC alongside changes in patient care after the administration of insulin/dextrose resulted in more appropriate use of insulin/dextrose, as well as a significant (73%) reduction in the iatrogenic burden of hypoglycaemia (P = 0.04).

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减少使用胰岛素和葡萄糖治疗高钾血症的危害。
住院患者使用胰岛素和葡萄糖治疗高钾血症可能会因先天性低血糖而变得复杂。我们试图评估住院肾病患者的低血糖发生率,并评估引入当地指南对中度高钾血症患者使用环硅酸锆钠(SZC)的影响。在最初的观察期中,低血糖的发生率较高,因此在指南中加入了在使用胰岛素治疗高钾血症后每小时进行毛细血管血糖监测(最长 6 小时)的要求。在使用胰岛素/葡萄糖后,在改变患者护理方式的同时两次引入 SZC,从而更合理地使用胰岛素/葡萄糖,并显著(73%)减少了低血糖的先天性负担(P=0.04)。
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来源期刊
Clinical Medicine
Clinical Medicine 医学-医学:内科
CiteScore
7.20
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: Clinical Medicine is aimed at practising physicians in the UK and overseas and has relevance to all those managing or working within the healthcare sector. Available in print and online, the journal seeks to encourage high standards of medical care by promoting good clinical practice through original research, review and comment. The journal also includes a dedicated continuing medical education (CME) section in each issue. This presents the latest advances in a chosen specialty, with self-assessment questions at the end of each topic enabling CPD accreditation to be acquired. ISSN: 1470-2118 E-ISSN: 1473-4893 Frequency: 6 issues per year
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