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Effects of Dexmedetomidine on Blood Glucose and SerumPotassium Levels in Children Undergoing General Anesthesia: A Secondary Analysis of Safety Endpoints During a Randomized Controlled Trial. Dexmedetomidine is a highly selective α2-adrenergic agonist, which is increasingly used in pediatric anesthesia and intensive care. Potential adverse effects that have not been rigorously evaluated in children include its effects on blood glucose and serumpotassium concentrations, which are relevant due (...) . Changes in plasma glucose and serumpotassium concentrations were measured in venous blood sampled before and at 15 and 30 minutes after study drug administration. Data were plotted within and between groups and analyzed using a constrained longitudinal data approach.Forty-nine children completed the study. Mean glucose levels at 15 and 30 minutes were elevated with estimated changes from baseline of 0.37 mmol/L (95% CI, 0.29-0.45 mmol/L) and 0.05 mmol/L (95% CI, 0.00-0.10 mmol/L), respectively. At 15
How closely do blood gas electrolytes and haemoglobin agree with serum values in adult emergency department patients: An observational study. The aims of this study were to establish the bias (mean difference) and 95% limits of agreement (LoA) between electrolyte values (sodium and potassium) and haemoglobin between whole blood analysed by the ED resuscitation room blood gas analyser and specimens analysed using standard techniques in the central hospital laboratory and to determine (...) (95% LoA -3.3 to 4.6 mmol/L). For potassium concentration the bias was 0.21 mmol/L (95% LoA -0.36 to 0.79 mmol/L). For haemoglobin concentration the bias was -1.6 g/dL (95% LoA -10.2 to 6.9 g/dL). For sodium and haemoglobin concentrations, >95% of results fell within the defined clinically acceptable limits. For potassium concentration, >90% of results fell within the defined clinically acceptable limits. In general, serum sodium and potassium concentrations were slightly higher than blood gas
Agreement of serumpotassium measured by blood gas and biochemistry analyzer in patients with moderate to severe hyperkalemia. Several studies investigated the agreement between central laboratory biochemistry analyzers and blood gas analyzers for potassium measurements. However, data are scarce when the potassium level is moderate to severely high. We aimed to evaluate the agreement between central laboratory biochemistry analyzers and blood gas analyzer in terms of serumpotassium level (...) measurement because differences in potassium at this level translate into very different clinical actions.This was a retrospective medical record review study in which patients who presented to the emergency department and had serumpotassium levels ≥6mmol/L were included. Patients who did not have simultaneous potassium measurement by blood gas analyzer were excluded. We included all patients meeting potassium criteria irrespective of their underlying disease or comorbidities. We evaluated agreement
Effect of dialysate potassium and lactate on serumpotassium and bicarbonate concentrations during daily hemodialysis at low dialysate flow rates. Observational studies of hemodialysis patients treated thrice weekly have shown that serum and dialysate potassium and bicarbonate concentrations are associated with patient outcomes. The effect of more frequent hemodialysis on serumpotassium and bicarbonate concentrations has rarely been studied, especially for treatments at low dialysate flow (...) rate.These post-hoc analyses evaluated data from patients who transferred from in-center hemodialysis (HD) to daily HD at low dialysate flow rates during the FREEDOM Study. The primary outcomes were the change in predialysis serumpotassium and bicarbonate concentrations after transfer from in-center HD (mean during the last 3 months) to daily HD (mean during the first 3 months).After transfer from in-center HD to daily HD (data from 345 patients, 51 ± 15 years of age, mean ± standard deviation
Low serumpotassium levels and diabetes - An unfavorable combination in patients with heart failure and preserved ejection fraction. Heart failure with preserved ejection fraction (HFpEF) is among the most common forms of heart failure (HF). We aimed to investigate the prognostic significance of serumpotassium levels and its interaction with type-2 diabetes mellitus in patients with HFpEF.Consecutive HFpEF patients were prospectively included in a registry study. The primary endpoint (...) was a composite of cardiac death or HF hospitalization.363 HFpEF patients were enrolled (median age: 73.0 years; females: 70.3%). Median serumpotassium (K+) was 4.3 mmol/L. A total of 128 (35.3%) patients had type-2 diabetes mellitus, of whom 92 were treated with oral anti-diabetic drugs and 35 with insulin. The study population was divided into two groups, according to their serumpotassium levels. Significant differences between the groups were detected with regards to combined endpoint [n = 27 (61.4
Use of potassium adsorption filter for the removal of ammonia and potassium from red blood cell solution for neonates. Ammonia in the plasma usually does not pass through the blood-brain barrier (BBB). However, it can affect the brain as a neurotoxin in neonates with anemia of prematurity. Excess intake of ammonia should therefore be restricted in conditions involving BBB breakdown, such as in premature neonates. A potassium adsorption filter (PAF) can remove not only potassium, but also (...) ammonia from red blood cell (RBC) solution. PAF for neonates (PAF-n) has been recently introduced using small satellite packs. We evaluated the effects of PAF-n on the removal of ammonia and potassium from RBC solution in small satellite packs.RBC solutions were obtained from the Japanese Red Cross Society. Two units of RBC solution (280 mL) were divided into four satellite packs (70 mL/pack). The RBC solution was passed through PAF-n (Kawasumi Laboratories Inc.) that was primed with saline (100 mL
Prognostic role of serum sodium levels across different serumpotassium levels in heart failure patients: A Danish register-based cohort study. In heart failure (HF), evidence on the prognosis of simultaneously abnormal sodium and potassium levels remains unknown. Therefore, we investigated associations between sodium levels and 90-day all-cause mortality across potassium levels in HF patients.Using Danish registers, we identified HF patients with sodium and potassium levels within 90 days (...) following a redeemed loop diuretic prescription from 2000 to 2012. We grouped sodium (<139, 139-143, >143 mmol/L) and potassium levels (<3.5 [hypokalemia], 3.5-4.0, 4.1-4.6, 4.7-5.0, >5.0 mmol/L [hyperkalemia]). First, by adjusting for potassium groups using multivariable Cox regression, we compared mortality of sodium <139 mmol/L and >143 mmol/L with 139-143 mmol/L as reference. Second, by combining sodium and potassium groups, we compared mortality of the resulting 15 combinations using sodium 139
Veltassa (patiromer for oral suspension) - To treat hyperkalemia, a serious condition in which the amount of potassium in the blood is too high Veltassa (Patiromer) Powder for Oral Suspension U.S. Department of Health and Human Services Search FDA Submit search Veltassa (Patiromer) Powder for Oral Suspension Veltassa Company: Relypsa, Inc. Application No.: 205739 Approval Date: 10/21/2015 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634
KCNJ11 variants and their effect on the association between serumpotassium and diabetes risk in the Atherosclerosis Risk in Communities (ARIC) Study and Jackson Heart Study (JHS) cohorts. In the Atherosclerosis Risk in Communities (ARIC) Study and Jackson Heart Study (JHS) cohorts, serumpotassium (K) is an independent predictor of diabetes risk, particularly among African-American participants. Experimental studies show that serum K levels affects insulin secretion. The KCNJ11 gene encodes (...) for a K channel that regulates insulin secretion and whose function is affected by serum K levels. Variants in KCNJ11 are associated with increased diabetes risk. We hypothesized that there could be a gene-by-environment interaction between KCNJ11 variation and serum K on diabetes risk.Evaluating a combined cohort of ARIC and JHS participants, we sought to determine if KCNJ11 variants are risk factors for diabetes; and if KCNJ11 variants modify the association between serum K and diabetes risk. Among
SerumPotassium Levels and Risk of Sudden Cardiac Death Among Patients With Chronic Kidney Disease and Significant Coronary Artery Disease Chronic kidney disease (CKD) patients have increased risks of sudden cardiac arrest and sudden cardiac death (SCA/SCD) that are not explained by traditional risk factors. We examined associations between serumpotassium and SCA/SCD in a large cohort of patients with coronary artery disease (CAD) and moderate CKD.Among 22,009 patients who underwent cardiac (...) with a doubling in SCA/SCD risk (adjusted odd ratio: 2.37; 95% confidence interval: 1.33-4.23) whereas there was no significant relationship between hypokalemia and outcome.Among CKD patients with significant CAD, elevated serumpotassium levels >5.0 mEq/l are common and are associated with an increased short-term risk of SCA/SCD. Early detection and treatment of hyperkalemia may reduce the high risk of SCD among CKD patients.
Admission serum sodium and potassium levels predict survival among critically ill patients with acute kidney injury: a cohort study. Patients suffering from acute kidney injury (AKI) were associated with impaired sodium and potassium homeostasis. We aimed to investigate how admission serum sodium and potassium independently and jointly modified adverse clinical outcomes among AKI patients.Patient data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III (...) . Participants were categorized into three groups according to admission serum sodium and potassium, and the cut-off values were determined using smooth curve fitting. The primary outcome was 90-day mortality in the intensive care unit (ICU). Cox proportional hazards models were used to evaluate the prognostic effects of admission serum sodium and potassium levels.We included 13,621 ICU patients with AKI (mean age: 65.3 years; males: 55.4%). The middle category of admission serum sodium and potassium levels
Examining the "Repletion Reflex": The Association between SerumPotassium and Outcomes in Hospitalized Patients with Heart Failure. In patients hospitalized with heart failure (HF) exacerbations, physicians routinely supplement potassium to maintain levels ≥4.0 mEq/L. The evidence basis for this practice is relatively weak. We aimed to evaluate the association between serumpotassium levels and outcomes in patients hospitalized with HF.We identified patients admitted with acute HF exacerbations (...) to hospitals that contributed to an electronic health record-derived dataset. In a subset of patients with normal admission serumpotassium (3.5-5.0 mEq/L), we averaged serumpotassium values during a 72-hour exposure window and categorized as follows: <4.0 mEq/L (low normal), 4.0-4.5 mEq/L (medium normal), and >4.5 mEq/L (high normal). We created multivariable models examining associations between these categories and outcomes.We included 4,995 patients: 2,080 (41.6%), 2,326 (46.6%), and 589 (11.8
Associations between serumpotassium and adverse clinical outcomes: a systematic literature review. Despite the growing body of evidence characterising the association between serumpotassium levels and adverse clinical outcomes, a contemporary summary of available evidence is currently lacking. The objective of this study, therefore, was to undertake a systematic literature review to identify all relevant evidence assessing risk factors associated with the incidence of hyperkalaemia (HK (...) ) and also quantifying the effect of serumpotassium levels on risk of adverse clinical outcomes.PubMed (Medline and Medline In-Process), Embase and the Cochrane Library were searched for studies published between January 2002 and November 2018. Search inclusion criteria included studies describing either the incidence of HK events and any associated risk factors, or associations between HK or serumpotassium concentration and adverse clinical outcomes including mortality, hospitalisation, major adverse
Racial and Ethnic Differences in Mortality Associated with SerumPotassium in Incident Peritoneal Dialysis Patients. Abnormalities in serumpotassium are risk factors for sudden cardiac death and arrhythmias among dialysis patients. Although a previous study in hemodialysis patients has shown that race/ethnicity may impact the relationship between serumpotassium and mortality, the relationship remains unclear among peritoneal dialysis (PD) patients where the dynamics of serumpotassium is more (...) stable.Among 17,664 patients who started PD between January 1, 2007 and December 31, 2011 in a large US dialysis organization, we evaluated the association of serumpotassium levels with all-cause and arrhythmia-related deaths across race/ethnicity using time-dependent Cox models with adjustments for demographics. We also used restricted cubic spline functions for serumpotassium levels to explore non-linear associations.Baseline serumpotassium levels were the highest among Hispanics (4.2 ± 0.7 mEq/L
The association of concomitant serumpotassium and glucose levels and in-hospital mortality in patients with acute myocardial infarction (AMI). Soroka acute myocardial infarction II (SAMI-II) project. Acute myocardial infarction (AMI) is associated with significant systemic metabolic changes. These changes include increased plasma concentrations of counter-regulatory hormones and changes in potassium (K, mEq/L) and glucose (mg/dL) levels. The latter are associated with outcomes and investigated (...) as potential focus for intervention; glucose-insulin‑potassium (GIK) solution.To evaluate the associations of concomitant K and glucose (K/glucose) levels with in-hospital mortality in AMI patients.AMI patients hospitalized in a tertiary Medical Center through 2002-2012 were studied. K/glucose levels were divided into equally sized categories. The intermediate category (glucose 124-143 mg/dL, K 4-4.9 mEq/L) was the reference group. The associations of these tests with the outcome were assessed using
Cut-off values of serumpotassium and core temperature at hospital admission for extracorporeal rewarming of avalanche victims in cardiac arrest: A retrospective multi-centre study. Evidence of existing guidelines for the on-site triage of avalanche victims is limited and adherence suboptimal. This study attempted to find reliable cut-off values for the identification of hypothermic avalanche victims with reversible out-of-hospital cardiac arrest (OHCA) at hospital admission. This may enable (...) values, and receiver operating curves.In total, 103 avalanche victims with OHCA were included. Of the 103 patients 61 (58%) were rewarmed by ECLS. Six (10%) of the rewarmed patients survived whilst 55 (90%) died. We obtained optimal cut-off values of 7 mmol/L for serumpotassium and 30 °C for core temperature.For in-hospital triage of avalanche victims admitted with OHCA, serumpotassium accurately predicts survival. The combination of the cut-offs 7 mmol/L for serumpotassium and 30 °C for core
How low can the potassium and sodium go with commonly prescribed blood pressure medications? Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,400 family physicians, family medicine residents and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care (...) research. www.acfp.ca May 24, 2016 How low can the potassium and sodium go with commonly prescribed blood pressure medications? Clinical Question: What is the risk of electrolyte disturbances with diuretics and ACE Inhibitors and when should we check? Bottom-line: Moderate hyponatremia (Na 5.4 mmol/L) occurs in 4% of ACE inhibitor (and angiotensin receptor blocker) users. Limited evidence suggests checking electrolytes in the first 2-4 weeks after starting, and again after increasing doses
Effect of different doses of chlorthalidone on blood pressure, serumpotassium, and serum urate. Chlorthalidone given to 40 hypertensive women significantly decreased blood pressure and serumpotassium levels and increased the serum urate concentration. There were no individual correlations between the reduction in blood pressure and the decrease in serumpotassium or the increase in serum urate. A reduction in dosage from 50 mg daily to 50 mg three times a week produced no significant (...) changes in the diastolic or mean blood pressures though the systolic blood pressure was moderately increased. Concomitantly, serumpotassium increased and serum urate decreased significantly on the lower chlorthalidone dose. We conclude that high doses of oral diuretics compared with lower ones are of limited further benefit and may increase the risk of clinically significant hypokalaemia and hyperuricaemia.
Evaluation of Serum Lipid, Thyroid, and Hepatic Clinical Chemistries in Association With Serum Perfluorooctanesulfonate (PFOS) in Cynomolgus Monkeys After Oral Dosing With Potassium PFOS An oral dose study with perfluorooctanesulfonate (PFOS) was undertaken to identify potential associations between serum PFOS and changes in serum clinical chemistry parameters in purpose-bred young adult cynomolgus monkeys (Macaca fascicularis). In this study, control group (n = 6/sex) was sham-dosed (...) with vehicle (0.5% Tween 20 and 5% ethanol in water), low-dose group (n = 6/sex) received 1 single K+PFOS dose (9 mg/kg), and high-dose group (n = 4-6/sex) received 3 separate K+ PFOS doses (11-17.2 mg/kg). Monkeys were given routine checkups and observed carefully for health problems on a daily basis. Scheduled blood samples were drawn from all monkeys prior to, during, and after K+PFOS administration for up to 1 year and they were analyzed for PFOS concentrations and clinical chemistry markers