Podcast 759: Hyperkalemia and Myth of Kayexalate

Podcast 759: Hyperkalemia and Myth of Kayexalate

Contributor: Nick Tsipis, MD

Educational Pearls:

  • Acute hyperkalemia is characterized as serum K of 5.4 or higher in non-hemolyzed samples
  • Hyperkalemia is commonly associated with end stage renal disease, acute kidney injury or acute renal failure
  • Cardiac dysrhythmias are the primary concern with hyperkalemia, common EKG changes (and approximate serum levels) can include:
    • Peaked T waves that start to show at serum K of 6
    • Second sign is lengthening of PR and QRS intervals due to extended repolarization
    • Severe hyperkalemia manifests as a sine wave around serum of 8-9
  • Three approaches to treat hyperkalemia:
    • Stabilize cardiac membrane with calcium
    • Shift potassium back into the cell, insulin and albuterol are common agents used.
    • Potassium binding for excretion
  • Cochrane review showed no significant effects of Kayexalate on serum K in 4 hours
  • Bowel necrosis is a rare adverse event that can occur with Kayexalate
  • More myths and misconceptions about hyperkalemia addressed in reference below!

References:

Gupta AA, Self M, Mueller M, Wardi G, Tainter C. Dispelling myths and misconceptions about the treatment of acute hyperkalemia. Am J Emerg Med. 2022;52:85-91. doi:10.1016/j.ajem.2021.11.030

Mahoney BA, Smith WA, Lo DS, Tsoi K, Tonelli M, Clase CM. Emergency interventions for hyperkalaemia. Cochrane Database Syst Rev. 2005;2005(2):CD003235. Published 2005 Apr 18. doi:10.1002/14651858.CD003235.pub2

Li T, Vijayan A. Insulin for the treatment of hyperkalemia: a double-edged sword?. Clin Kidney J. 2014;7(3):239-241. doi:10.1093/ckj/sfu049

Summarized by Mason Tuttle| Edited by Nick Tsipis, MD

Jaksot(1150)

Podcast 853: Critical Care Medications - Vasopressors

Podcast 853: Critical Care Medications - Vasopressors

Contributor: Travis Barlock MD Educational Pearls: Three categories of pressors: inopressors, pure vasoconstrictors, and inodilators Inopressors:  Epinephrine - nonselective beta- and alpha-adr...

29 Touko 20235min

Podcast 852: Angioedema After Thrombolysis

Podcast 852: Angioedema After Thrombolysis

Contributor: Aaron Lessen, MD Educational Pearls: What is thrombolysis? Thrombolysis is performed by administration of a medication that promotes the body's natural ability to break up clots. These ...

22 Touko 20232min

Podcast 851: High-Dose Nitroglycerin in SCAPE

Podcast 851: High-Dose Nitroglycerin in SCAPE

Contributor: Aaron Lessen MD Educational Pearls: SCAPE (Sympathetic Crashing Acute Pulmonary Edema), formerly known as flash pulmonary edema, is a life-threatening condition due to a sudden sympathet...

15 Touko 20233min

Podcast 850: Cardiac Arrest - Entertainment vs. Reality

Podcast 850: Cardiac Arrest - Entertainment vs. Reality

Contributor: Travis Barlock, MD Educational Pearls: Sudden Cardiac Arrest (SCA) is defined as when the heart suddenly stops beating. Immediate treatment for SCA includes Cardiopulmonary Resuscitation ...

8 Touko 20232min

Mental Health Monthly #15: Psychosis in the ED: Part I

Mental Health Monthly #15: Psychosis in the ED: Part I

Contributors: Andrew White MD & Travis Barlock MD In this episode of Mental Health Monthly, Dr. Andrew White, a practicing psychiatrist with an addiction medicine fellowship, and Dr. Travis Barlock, a...

3 Touko 202331min

Podcast 849: Large Vessel Occlusions

Podcast 849: Large Vessel Occlusions

Contributor: Travis Barlock MD Educational Pearls:  Large Vessel Occlusion (LVO) is a condition where a clot blocks one of the major blood vessels in the brain, leading to a stroke. What are the vesse...

1 Touko 20233min

Podcast 848: Non-Traditional RSI

Podcast 848: Non-Traditional RSI

Contributor: Meghan Hurley, MD Educational Pearls: Two main reasons to choose non-traditional RSI Anatomically challenging airway Physiologically difficult patients: hypoxia, metabolic acidosi...

24 Huhti 20235min

Podcast 847: ECMO CPR

Podcast 847: ECMO CPR

Contributor: Aaron Lessen, MD Educational Pearls: Extracorporeal Membrane Oxygenation (ECMO) has been attempted as an adjunct to CPR during cardiac arrest but few studies on outcomes exist One prior...

6 Helmi 20233min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
mielipaivakirja
filocast-filosofian-perusteet
rss-metsantuntijat-podcast
rss-ylistys-elaimille
university-of-eastern-finland
utelias-mieli
radio-antro
rss-bios-podcast
rss-ranskaa-raakana
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-lihavuudesta-podcast
rss-sosiopodi