Clinical Trial: Safety of Continuous Potassium Chloride Infusion in Critical Care
Study Status: Completed
Recruit Status: Completed
Study Type: Interventional
Official Title: Assessing the Safety of a Continuous Potassium Chloride Infusion in Critical Care: A Randomised Controlled Trial
Brief Summary: Patients in critical care often require supplemental potassium chloride if levels in their blood are below acceptable level. Common practice is to administer a single dose of potassium chloride under controlled conditions via a drip, before checking if a further dose is required. The purpose of this study is to ensure that it is safe to administer potassium chloride continuously with the dose varied according to patient needs.
Detailed Summary:
The use of potassium supplementation is commonplace in the critical care environment. Patients often have abnormal serum potassium levels due to active disease processes. Conditions such as acute renal failure and metabolic acidosis precipitate hyperkalaemia, with ileus and insensible losses causing hypokalaemia. Both hypo- and hyperkalaemia can cause life-threatening arrythmias so it is prudent to rectify aberrant levels.
The standard treatment of hypokalaemia in intensive care units is by intravenous administration of potassium chloride. This can be given either as a dilute solution as maintenance intravenous fluid therapy, or as a concentrated solution by intermittent infusion. Alternatively potassium can be given as a concentrated solution by continuous infusion. All techniques require regular monitoring of the patient's serum potassium level with appropriate alterations to the administration regime.
From a theoretical standpoint it would make sense to give potassium by continuous infusion as this allow slow but steady correction of hypokalaemia. A continuous infusion should prevent rapid fluctuations in the serum level that could be caused by intermittent infusions, which may precipitate arrhythmia. However continuous infusions require vigilant monitoring to ensure that hyperkalaemia does not occur and must be given into a central vein to avoid the risk of phlebitis.
The use of intermittent infusions has been used safely in the critical care setting under physician guidance. A retrospective review reported the outcomes of the administration of 495 infusion sets to 190 individuals. While they identified 2 instances of post-infusion hyperkalaemia, neither was associated with any adverse sequelae. Analysis showed a no correlation between serum potassium increase post-infu
Sponsor: The Queen Elizabeth Hospital
Current Primary Outcome: Adherence to a potassium level 4.0 - 4.5mmol/L [ Time Frame: 7 days ]
Original Primary Outcome: Adherence to a potassium level 4.0 - 4.5mmol/L [ Time Frame: Throughout study ]
Current Secondary Outcome:
- Total quantity of potassium administered [ Time Frame: 7 days ]
- Incidence of potassium level < 3.0mmol/L and > 5.5mmol/L [ Time Frame: 7 days ]
- Incidence of arrhythmia [ Time Frame: 7 days ]
- Number of arterial blood gases taken [ Time Frame: 7 days ]
Original Secondary Outcome:
- Total quantity of potassium administered [ Time Frame: At end of study ]
- Incidence of potassium level < 3.0mmol/L and > 5.5mmol/L [ Time Frame: Throughout study ]
- Incidence of arrhythmia [ Time Frame: At end of study ]
- Number of arterial blood gases taken [ Time Frame: At end of study ]
Information By: The Queen Elizabeth Hospital
Dates:
Date Received: July 16, 2008
Date Started: October 2008
Date Completion:
Last Updated: July 26, 2010
Last Verified: November 2009
