Accuracy of Potassium Supplementation of Fluids Administered Intravenously

Journal of Veterinary Internal Medicine

S. N. Hoehne²  K. Hopper¹ 

[1] Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA;William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA

关键词: Additives;    Crystalloid fluids;    Electrolytes;    Hyperkalemia;    Mixing;   

DOI  :  10.1111/jvim.12588

来源: Wiley

【 摘 要 】

Abstract

Background

Potassium (K⁺) supplementation of isotonic crystalloid fluids in daily fluid therapy is commonly performed, yet its accuracy in veterinary medicine is undetermined.

Objective

To investigate the accuracy of K⁺ supplementation in isotonic crystalloid fluids.

Animals

None.

Methods

Observational study. 210 bags of fluid supplemented with KCl being administered to hospitalized dogs and cats intravenously (IV) were sampled over a 3-month period. Measured K⁺ concentration ([K⁺]) was compared to the intended [K⁺] of the bag. In a second experiment, 60 stock fluid bags were supplemented to achieve a concentration of 20 mmol/L K⁺, mixed well and [K⁺] was measured. In another 12 bags of 0.9% NaCl, K⁺ was added without mixing the bag, and [K⁺] of the delivered fluid was measured at regular time points during constant rate infusion.

Results

The measured [K⁺] was significantly higher than intended [K⁺] (mean difference 9.0 mmol/L, range 6.5 to >280 mmol/L, P < .0001). In 28% of clinical samples measured [K⁺] was ≥5 mmol/L different than intended [K⁺]. With adequate mixing, K⁺ supplementation of fluids can be accurate with the mean difference between measured and intended [K⁺] of 0.7 (95% CI −0.32 to 1.7) mmol/L. When not mixed, K⁺ supplementation of 20 mmol/L can lead to very high [K⁺] of delivered fluid (up to 1410 mmol/L).

Conclusions and Clinical Importance

Inadequate mixing following K⁺ supplementation of fluid bags can lead to potentially life threatening IV infused [K⁺]. Standard protocols for K⁺ supplementation should be established to ensure adequate mixing.

【 授权许可】

CC BY-NC   
Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.