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(1144)

Episode 934: Subendocardial Ischemia

Episode 934: Subendocardial Ischemia

Contributor: Travis Barlock MD Educational Pearls: What is the ST segment? The ST segment on an ECG represents the interval between the end of ventricular depolarization (QRS) and the beginning of v...

9 Joulu 20243min

Episode 933: Benign Convulsions with Gastroenteritis

Episode 933: Benign Convulsions with Gastroenteritis

Contributor: Alec Coston MD Educational Pearls: Causes of seizures in a fairly well-appearing child with diarrhea: Electrolyte abnormalities: hypocalcemia, hyponatremia Also hyperkalemia which...

2 Joulu 20243min

Episode 932: Induction Agent Hypotension

Episode 932: Induction Agent Hypotension

Contributor: Aaron Lessen MD Educational Pearls: Induction agent selection during rapid sequence intubation involves accounting for hemodynamic stability in the post-intubation setting Many emerge...

25 Marras 20242min

Episode 931: Naloxone in Cardiac Arrest

Episode 931: Naloxone in Cardiac Arrest

Contributor: Aaron Lessen MD Educational Pearls: Can opioids cause cardiac arrest? Opioids can cause respiratory suppression and the subsequent low oxygen levels can lead to arrhythmias and eventual...

18 Marras 20243min

Episode 930: Holding Costs

Episode 930: Holding Costs

Contributor: Aaron Lessen MD Educational Pearls: A study evaluated the patient-care impact and financial costs of holding patients in the ED, a nationwide issue Prospective, observational study o...

15 Marras 20242min

Episode 929: Traumatic Aortic Injury

Episode 929: Traumatic Aortic Injury

Contributor: Aaron Lessen MD Educational Pearls: Aortic injury occurs in 1.5-2% of patients who sustain blunt thoracic trauma Majority are caused by automobile collisions or motorcycle accidents ...

4 Marras 20245min

Laboring Under Pressure Episode 4: Obstetric Emergency in South Africa with Dr. Meghan Hurley

Laboring Under Pressure Episode 4: Obstetric Emergency in South Africa with Dr. Meghan Hurley

Laboring Under Pressure Episode 4: Obstetric Emergency in South Africa with Dr. Meghan Hurley Contributors: Meghan Hurley MD, Travis Barlock MD, Jeffrey Olson MS3 Show Pearls Map of South Africa Refer...

31 Loka 202427min

Episode 928: Neutropenic Fever

Episode 928: Neutropenic Fever

Contributor: Taylor Lynch, MD Educational Pearls: What is neutropenic fever? Specific type of fever that is seen in cancer patients and other patients with impaired immune systems These patients a...

28 Loka 20245min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
tiedekulma-podcast
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
radio-antro
filocast-filosofian-perusteet
rss-laakaripodi
rss-lihavuudesta-podcast
rss-sosiopodi
ihanat-ipanat
sotataidon-ytimessa
mielipaivakirja
rss-radplus
rss-opeklubi