Abstract
A common reason that often makes clinicians hesitate to use balanced crystalloids in the emergency department is the risk of unexpected hyperkalemia in patients with decreased renal function. In this single-center retrospective cohort study, we compared the change in potassium levels before and after administrating a balanced crystalloid, Plasma Solution A, in patients with normal and decreased renal function. Patients who were administered Plasma Solution A and had an electrolyte follow-up potassium test within 24 hours were included. Decreased renal function was defined as an estimated glomerular filtration rate (eGFR) of less than 90 mL/min/1.73 m2. A total of 1134 patients were included, comprising 376 patients with normal renal function (an eGFR >90 mL/min/1.73 m2) and 758 patients with decreased renal function. In patients with decreased renal function, the mean administered Plasma Solution A volume (mL/kg, mean (SD)) was 34.0 (20.1). The mean administration duration (hr, mean (SD)) was 13.9 (4.7). The eGFR (mL/min/1.73 m2, mean (SD)) increased from 52.6 (24.4) to 68.0 (37.6) (p < 0.05), and the potassium level (mmol/L, mean (SD)) decreased from 4.4 (0.6) to 4.1 (0.6) (p < 0.05). Altogether, we found that the potassium level and renal function may not be worsened in patients with decreased renal function within 24 hours after the intravenous administration of approximately 2 L of a balanced crystalloid in the emergency department.
Subject
History,History and Philosophy of Science,Multidisciplinary,Social Sciences (miscellaneous),Geography, Planning and Development,Marketing,Strategy and Management,Industrial relations,Business and International Management,Business, Management and Accounting (miscellaneous),Management of Technology and Innovation,Management Science and Operations Research,Information Systems and Management,Organizational Behavior and Human Resource Management,Electrical and Electronic Engineering,Computer Science Applications,Mechanical Engineering,Transportation,Computational Mechanics,Management Science and Operations Research,Computer Science Applications,Theoretical Computer Science,Computer Science Applications,General Mathematics,Software,Political Science and International Relations,Sociology and Political Science,Mechanical Engineering,Mechanics of Materials,Algebra and Number Theory