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Serum Potassium (serum + potassium)
Terms modified by Serum Potassium Selected AbstractsManagement of new onset atrial fibrillation in previously well patients less than 60 years of ageEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2005David McD Taylor Abstract Objective:, This study reviewed the ED management of new onset atrial fibrillation (AF) in previously well patients aged less than 60 years. Methods:, We undertook a retrospective review of ED patients from 1998 to 2002 inclusive. The main outcome measures were approaches to rate or rhythm control and anticoagulation, the use of echocardiography, the value of diagnostic testing and the frequency of hospital admission. Results:, Fifty-two patients were identified. In general, all patients were haemodynamically stable. One patient had mild cardiac failure and one was clinically thyrotoxic. Serum potassium was measured in 51 (98%) patients, magnesium in 23 (44%) and cardiac enzymes in 30 (58%); results were generally unhelpful. Thyroid function tests were carried out in 40 (77%) patients; results were unremarkable except for the clinically thyrotoxic patient. No patient had echocardiography in the ED; however, 6 patients (12%) were later found to have major cardiac abnormalities. Forty-four (85%) patients received a variety of medications; 37 (71%) received an anti-arrhythmic and 24 (46%) an antithrombotic. Overall, 17 (33%) patients received theoretically effective therapy for conversion to sinus rhythm. Twenty-two (42%) patients were admitted to hospital. Conclusions:, This study reveals variation in the management of acute AF in previously well, haemodynamically stable, young patients. Pathology testing was frequently carried out with a low yield. There were high rates of attempts to cardiovert, use of antithrombotics and of admission to hospital. Although cardioversion attempts appeared to be contrary to existing guidelines, decisions may have been based primarily on patient symptoms. Echocardiography should be considered prior to anti-arrhythmic therapy. [source] Physical assessment of patients with anorexia nervosa and bulimia nervosa: an international comparisonEUROPEAN EATING DISORDERS REVIEW, Issue 6 2003D. Kovacs Abstract Objective: A questionnaire study was carried out to determine which investigations were carried out routinely on patients with anorexia nervosa and bulimia nervosa. Method: A specially designed questionnaire was sent to 168 clinicians working in the field of eating disorders in 25 countries. Respondents were asked to supply information about how often they carry out specific investigations on new patients with AN and BN. The questionnaire covered the use of physical examination, biochemical and haematological tests and cardiac investigations. Results: 71,(42.3,per cent) questionnaires were returned. Biochemical investigations and full blood counts were carried out frequently. Significant differences were found between AN patients and BN patients in the measurement of calcium, phosphate and magnesium levels. In some cases, patients with BN were not routinely assessed for hypokalaemia. Micronutrient levels were measured rarely and only 40,per cent of respondents carried out routine electrocardiograms (ECGs) in AN. Discussion: Measurement of serum potassium should be routine in BN and other electrolytes should probably measured more often in both disorders. Detection of treatable micronutrient deficiencies should be given more emphasis and the ECG should become a routine investigation in AN. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Alterations in electrolyte equilibrium in patients with acute leukemiaEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2005Theodosios D. Filippatos Abstract:,Background and aim:,A wide array of disturbances in electrolyte equilibrium is commonly seen in patients with acute leukemia (AL). These abnormalities present a potential hazard in these patients, as that of enhancing the cardiotoxic effects of certain chemotherapeutic regimens. The literature dealing with AL-related electrolyte abnormalities and their interactions in leukemic patients was reviewed. Data synthesis:,Sources included MEDLINE and EMBASE. The search strategy was based on the combination of ,acute leukemia', ,electrolyte abnormalities', ,acid-base disorders', ,potassium', ,sodium', ,magnesium', ,calcium', and ,phosphorus'. References of retrieved articles were also screened. A decrease in serum potassium, mainly owing to lysozyme-induced tubular damage, appears to be one of the most frequent and potentially hazardous abnormalities. Other clinically significant metabolic perturbations include hyponatremia and hypercalcemia. Conclusion:,A broad spectrum of electrolyte abnormalities is encountered in the clinical setting of AL, which are related to the disease process per se and/or to the therapeutic interventions. Clinicians should be vigilant for early detection and appropriate management of these disorders before the initiation of chemotherapy regimens as well as during treatment. [source] Clinical trial: the efficacy and safety of routine bowel cleansing agents for elective colonoscopy in persons with spinal cord injury , a randomized prospective single-blind studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2009H. R. ANCHA Summary Background, As difficulty with evacuation is a common occurrence in individuals with spinal cord injury, preparation prior to colonoscopy may be suboptimal and, perhaps, more hazardous. Aim, To assess the safety and efficacy of bowel cleansing regimens in persons with spinal cord injury. Methods, Randomized, prospective, single blind study comparing polyethylene glycol (PEG), oral sodium phosphosoda (OSPS) and combination of both for colonic preparation prior to colonoscopy in subjects with spinal cord injury. Results, Thirty six subjects with eGFR ,60 mL/min/1.73 m2 were randomized to PEG or OSPS or PEG+OSPS. Regardless of bowel preparation employed, >73% of subjects had unacceptable colonic cleansing. No subject in the OSPS preparation group demonstrated a decrease in eGFR or an increase in serum creatinine concentration from the baseline. OSPS and PEG+OSPS preparations caused a transient change in serum potassium, phosphate and calcium concentrations, but no change in electrolytes was noted in the PEG group. Conclusions, Neither OSPS alone, PEG alone nor their combination was sufficient to prepare adequately the bowel for colonoscopy in most patients with spinal cord injury. However, administration of OSPS and/or PEG appears to be safe in the spinal cord injury population, provided adequate hydration is provided. [source] Prevalence and Incidence of Serum Magnesium Abnormalities in Hospitalized CatsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2002Jeffrey Toll Total serum magnesium concentration ([Mg2+]s) was prospectively determined for 57 cats admitted to the intensive care unit (ICU) of the Cornell University Hospital for Animals. Data were collected and analyzed to determine the following: prevalence and incidence of [Mg2+]s abnormalities, medical disorders associated with altered [Mg2+]s, association of altered [Mg2+]s with other electrolyte abnormalities, length of hospitalization for cats with abnormalities of [Mg2+]s versus those with normal [Mg2+]s, and survival of cats with abnormal [Mg2+]s versus those with normal [Mg2+]s. The point prevalence of magnesium abnormalities was 26%, the period prevalence was 46%, and the cumulative incidence was 23%. Hypermagnesemia was associated with abnormalities of serum potassium (P= .04) and phosphate (P= .01) concentrations. Abnormalities of [Mg2+]s were not associated with abnormal serum concentrations of Na+, Ca2+, or Cl - . On admission, hypomagnesemia was detected in cats with gastrointestinal, endocrine, and other disorders; hypermagnesemia was detected only in cats with renal disease, obstructive uropathy, or neoplastic disease. The median hospital stay for cats that developed abnormal [Mg2+]s after admission was longer than for cats that remained nor-momagnesemic (5 versus 4 days, respectively; P= .03). Despite the longer hospital stay, the survival of these cats was lower than that of normomagnesemic cats (54 versus 77%; P= .05). When all cats were considered, the survival of cats with abnormal [Mg2+]s also was decreased compared with normomagnesemic cats (62 versus 81%; P= .05). We conclude that abnormalities of [Mg2+]s may affect morbidity and mortality of affected cats. [source] Review article: recognition and treatment of eating disorders in primary and secondary careALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2000Robinson Eating disorders are serious illnesses affecting 1,2% of young women. Patients may present to any doctor, sometimes atypically (e.g. unexplained weight loss, food allergy, infertility, diarrhoea), delaying diagnosis and leading to needless investigation. The cardinal signs are weight loss, amenorrhoea, bingeing with vomiting and other compensatory behaviours, and disturbances in body image with an exaggeration of the importance of slimness. When other causes have been excluded, useful investigations are serum potassium, bone mineral density scanning and pelvic ultrasound. In emaciated patients multiple systems may fail with pancytopaenia, neuromyopathy and heart failure. Clinical assessment of muscle power is used to monitor physical risk. Treatment may involve individual, group or family sessions, using cognitive-behavioural, psychodynamic and family approaches. More severe or intractable illness is treated with day care, with in-patient care in a medical or specialist psychiatric unit reserved for the most severely ill patients. Antidepressants have a place in the treatment of bulimia nervosa unresponsive to psychological approaches, and when severe depressive symptoms develop. The children of people with eating disorders may have an increased risk of difficulties. Support for the patient and family, and effective liaison between professionals, are essential in the treatment of severe eating disorders. [source] Safely treating hypokalaemia in high dependency cardiac surgical patientsNURSING IN CRITICAL CARE, Issue 6 2006Claire Sladdin Abstract In Australia, there were national issues on the use of potassium ampoules (resulting in patient deaths), which led to the removal of the ampoules from clinical areas. A decision was made by the Medication Safety Committee at a metropolitan Melbourne hospital to remove potassium ampoules from ward areas as part of the establishment of a hospital-wide potassium guideline. As a result, the nurses in the cardiothoracic ward Practice Review Committee identified the need to review the proposed practice of treating hypokalaemia with 30 mmol of potassium chloride (KCL) in 1000 mL over an extended period in postoperative cardiothoracic patients. The challenge was to develop a practice to safely administer intravenous KCL in fluid restricted patients in addition to the hospital guidelines to prevent hypokalaemic-induced cardiac dysrhythmias. A literature search revealed there were no clear or uniform approaches to guide our practice in addressing this clinical problem. The Practice Review Committee developed a KCL administration guideline based on a review of the available literature. The Practice Review Committee developed a ward-based guideline that addressed infusion concentration, duration of administration, responsiveness of nurses to severity of hypokalaemia and the evaluation of treatment by measuring serum potassium after replacement. This ward-based guideline was based on benchmarking from similar institutions and relevant literature. The review process provided an opportunity for the staff to critique their practice to improve patient care and allowed regular evaluation of the implemented practice guideline. The ward-based guideline required a revision as patients' renal function was not being taken into consideration prior to potassium infusions being administered. The implementation of the ward-based guideline into practice has been well received by the staff as it has allowed consistent practice and timely treatment of hypokalaemia. [source] Uses of proton pump inhibitors and serum potassium levels,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 9 2009Jen-Tzer Gau MD Abstract Purpose Proton pump inhibitor (PPI) may suppress adrenal cortical steroid synthesis and release, thereby leading to electrolyte disturbances. Both hyponatremia and hyperkalemia in the setting of PPI therapy have been documented in case reports. The objective of this study was to examine the association between serum potassium (K+) level and PPI use. Methods A retrospective data analysis of hospitalized adults aged ,65 years during 2006, including PPI users (N,=,257) and PPI non-users (N,=,388), was conducted. Multiple linear and logistic regression analyses were used to assess the association between PPI use and serum K+ level. Results PPI users [mean age (SD):79.7 (8.0) years; 70% female] had significantly higher serum K+ levels than PPI non-users [80.2 (8.8) years; 64% female] on admission [4.13 (0.62) vs. 3.97 (0.57) mmol/L; p,<,0.001]. The linear regression model revealed that ,2 defined daily dose (DDD) units of PPI use were a significantly positive contributor to serum K+ levels (p,=,0.021) after adjusting for age, serum creatinine levels, sex, history of diabetes, and uses of the following drugs: angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker, , blocker, diuretics, spironolactone, K+ supplement, non-steroidal anti-inflammatory drugs, atypical antipsychotics, and narcotics. However, multiple logistic regression model revealed that high dose PPI therapy was not associated with an increased risk for hyperkalemia occurrence (p,=,0.762). Conclusion Higher serum K+ levels were observed among PPI users when compared to PPI non-users. High daily dose PPI therapy may be an independent positive predictor of serum potassium levels. Copyright © 2009 John Wiley & Sons, Ltd. [source] Efficacy and safety of high-dose budesonide/formoterol (Symbicort®) compared with budesonide administered either concomitantly with formoterol or alone in patients with persistent symptomatic asthmaRESPIROLOGY, Issue 3 2006Christine JENKINS Objective and background: Budesonide/formoterol 160/4.5 µg, two inhalations bd, is an effective and well-tolerated maintenance therapy for patients not controlled on inhaled corticosteroids alone. The authors assessed the efficacy and safety of a higher dose of budesonide/formoterol in patients with persistent symptomatic asthma. Methods: This was a 24-week, double-blind, double-dummy randomized study. Budesonide/formoterol 320/9 µg, two inhalations bd (1280/36 µg/day), was compared with corresponding doses of budesonide during weeks 1,12 and budesonide plus formoterol via separate inhalers during weeks 1,24. Efficacy was assessed during weeks 1,12; the primary variable was morning PEF. Safety was assessed over weeks 1,24. Results: Patients (n = 456; aged 12,79 years) had a mean reversibility in FEV1 of 28% and mean pre-study inhaled corticosteroid dose of 1038 µg/day. Mean morning PEF increased by 37 L/min and 36 L/min with budesonide/formoterol and budesonide plus formoterol, respectively, versus an increase of 5 L/min with budesonide (P < 0.001 for both vs. budesonide). Budesonide/formoterol increased time to first mild exacerbation (P < 0.005) versus budesonide. Budesonide/formoterol and budesonide plus formoterol had similar efficacy. All treatments were well tolerated and the incidence of class-related adverse events was similarly low in all groups. Changes in serum potassium and plasma cortisol were comparable across treatments. Conclusions: High-dose budesonide/formoterol (320/9 µg, two inhalations bd) is effective and well tolerated in patients with persistent symptomatic asthma. The findings also support the safety of regular high-dose formoterol (36 µg/day). [source] Fetal demise despite normalisation of serum potassium in Gitelman syndrome Case report and literature reviewAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2010Nisha LAKHI No abstract is available for this article. [source] Safety of Spironolactone Use in Ambulatory Heart Failure PatientsCLINICAL CARDIOLOGY, Issue 11 2008Ricardo J. Lopes MD Abstract Background Since the Randomized Aldactone Evaluation Study (RALES), the use of spironolactone is recommended in systolic heart failure (HF) patients that have been in New York Heart Association (NYHA) class III or IV. There is limited information on the use, side effects, and withdrawal rate of spironolactone in routine clinical practice. Hypothesis Side effects related to spironolactone use are more common than reported in clinical trials. Methods Patients who had moderate to severe left ventricular systolic dysfunction (LVSD) under optimized medical therapy were included. We introduced spironolactone in those with serum potassium (K+) , 5 meq/L, and serum creatinine (Cr) , 2.5 mg/dL. Spironolactone was withdrawn if serum K + , 5.5 meq/L, serum Cr increased more than 30%, 50% of the baseline value, and/or if the patient had gynecomastia. Results We selected 134 patients followed in an HF clinic. In our sample, 56.7% of the patients (76 out of 134) were currently or had formerly been on spironolactone therapy. The rate of spironolactone withdrawal was 25% (19 out of 76). Reasons for suspension were hyperkalemia (17.1%), renal function deterioration (14.5%), gynecomastia (5.3% of males), and other reasons (1.3%). Conclusion Spironolactone side effects are common and are mostly related to effects on the angiotensin-aldosterone axis. Our results reinforce the need to closely monitor serum K+ and Cr levels in patients treated with spironolactone, as its side effects are more common than reported in clinical trials. Copyright © 2008 Wiley Periodicals, Inc. [source] Clinical and biochemical characteristics of normotensive patients with primary aldosteronism: a comparison with hypertensive casesCLINICAL ENDOCRINOLOGY, Issue 1 2008Virginie Médeau Summary Objective, It is unknown why some patients with biochemical evidence of primary aldosteronism (PA) do not develop hypertension. We aimed to compare clinical and biochemical characteristics of normotensive and hypertensive patients with PA. Design and patients, Retrospective comparison of 10 normotensive and 168 hypertensive patients with PA for office or ambulatory blood pressure, serum potassium, plasma aldosterone and renin concentrations; the aldosterone : renin ratio, and tumour size. Comparison of initial hormonal pattern and drop in blood pressure following adrenalectomy in five normotensive and nine hypertensive patients matched for age, sex and body mass index. Results, The 10 normotensive patients were women and presented with hypokalemia or an adrenal mass. Age, plasma aldosterone and renin concentrations were similar in normotensive and hypertensive cases, but kalemia and body mass index were significantly lower in the normotensive patients. Mean tumour diameter was larger in the normotensive patients than in the hypertensive matched patients with an adenoma (P < 0·01). In normotensive patients, diastolic blood pressure and upright aldosterone correlated negatively with kalemia. Blood pressure was lowered similarly after adrenalectomy in five normotensive PA patients and in their matched hypertensive counterparts. Aldosterone synthase expression was detected in four out of five adrenal tumours. Conclusions, Blood pressure may be normal in patients with well-documented PA. The occurrence of hypokalemia, despite a normal blood pressure profile, suggests that protective mechanisms against hypertension are present in normotensive patients. [source] Postoperative arrhythmias in colorectal surgical patients: incidence and clinical correlatesCOLORECTAL DISEASE, Issue 3 2006S. R. Walsh Abstract Objective, To determine the incidence and clinical correlates of postoperative cardiac arrhythmias in patients undergoing elective large bowel resection. Methods, Fifty-one consecutive patients undergoing elective open colorectal resection were recruited for this prospective observational study. Participating patients underwent daily three-lead electrocardiograms postoperatively. Data regarding potential risk factors for arrhythmias were recorded. Post-operative complications were recorded. Results, Thirteen (26%) patients developed a postoperative arrhythmia, most commonly atrial fibrillation. Significant univariate correlates with postoperative arrhythmias were: age (P < 0.01), hypertension (P < 0.01), pre-operative serum potassium levels (P < 0.01), postoperative pulmonary oedema (P = 0.03), postoperative serum potassium (P = 0.03) and sodium (P < 0.01). Arrhythmia patients were more likely to have other complications (P = 0.02). Thirty-one percent of arrhythmia patients had underlying sepsis compared with 18% of controls (P = 0.38). Conclusion, Arrhythmias are common following elective large bowel resection. They occur in older patients and are associated with the development of other complications. [source] Salbutamol for hyperkalaemia in childrenACTA PAEDIATRICA, Issue 11 2001E Helfrich Hyperkalaemia is a potentially fatal disorder that demands direct treatment. The efficacy of traditional medical treatment is unpredictable, limited, of short duration or carries the risk of serious adverse events. The administration of salbutamol for hyperkalaemia in children is described in several clinical trials and case reports. Conclusion: Salbutamol, inhaled or infused, is safe and efficacious and results in a predictable and long-lasting reduction in serum potassium. Salbutamol merits a place as the preferred medication for hyperkalaemia in children without arrhythmias. If follow-up with haemodialysis is required, the administration of salbutamol gives time to make the necessary preparations. [source] | ||||||||||