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CARDIOVASCULAR
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Volume 8, 2003, No 1-2 |
Treatment of Hyperkalemia with High Dose
Intravenous Insulin during Extracorporeal Circulation
H. Kocoglu, S. Goksu, S. Pence, B. Soykan, N. Yilmaz, T. Kocak
Background: Glucose-insulin infusion can be used in the
treatment of hyperkalemia seen in extracorporeal circulation (ECC) during
cardiac surgery. We aimed to investigate the relationship between the dose of
the insulin and the rate of decrease in blood potassium level.
Design: The study is designed to compare two different doses of insulin
in hyperkalemic patients during ECC.
Methods: Thirty six hyperkalemic patients, to whom continuous retrograde
warm blood cardioplegia was applied, were allocated to the study. Patients
having blood potassium level of 7 mmol/L and above were allocated to the group I
and of 6-7 mmol/L to group II. Fifty units of insulin was given intravenously to
the group I patients and 25 units to the group II patients. Blood potassium and
glucose level were monitored. The time to get the blood potassium level of 5.5
mmol / L, and complications were compared.
Results: The time to get blood potassium level of 5.5 mmol/L was 22.7 ±
1.9 min in group I, and 15.7 ± 0.8 min in group II (p<0.05). The decrease in
potassium level was 1.78 mmollL and the rate of decrease in blood potassium
level was 0.078 mmol /L lmin in group I, and 0.076 mmol /L and 0.048 mmollLlmin
in group II, respectively (p<0.05). Complication rate was higher in group I
(p<0.05).
Conclusions: This study is the first study about the doses of insulin in
patients with hyperkalemia during ECC. Insulin in the doses of 25-50 units can
be used safely in the treatment of hyperkalemia during ECC.
(CVE. 2003; 8 (1/2): 40-43)
Key words: insulin, hyperkalemia, extracorporeal circulation
Hasan Kocoglu, M.D.
Anesteziyoloji ve Reanimasyon AD
Gaziantep Universitesi Tip Fakultesi
27310 Gaziantep
Turkey
E-mail: hkocoglu@hotmail.com
PABST SCIENCE PUBLISHERS
Lengerich, Berlin, Riga, Rom,
Wien, Zagreb