Challenges in managing profound hypokalaemia

摘要

Abnormalities of serum potassium are associated with well described clinical features: lassitude when potassium < 3.5 mmol/1, possible muscle necrosis at < 2.5 mmol/1, and a flaccid paralysis with respiratory compromise at <2 mmol/1. World wide, hypokalaemia is most often caused by diarrhoea, although specific treatment of hypokalaemia is not mentioned in international guidelines for managing gastroenteritis. Furthermore, a recent case made us concerned that the potassium replacement recommended in medical texts (a maximum rate of infusion of 0.3-0.5 mmol/kg/hour and a maximum daily replacement of 3-5 mmol/kg) may be inadequate for profound hypokalaemia (≤1.5 mmol/1).