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Module 3 • Clinical Pharmacology
Fluids, Electrolytes, Acid-Base & Nutrition
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Fluids, Electrolytes, Acid-Base & Nutrition
Ashley Hawthorne ~3 min read Module 3 of 20
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Fluids, Electrolytes, Acid-Base Disorders, and Nutrition Support

2Hypokalemia

Definition: Serum potassium less than 3.5 mEq/L, though most ICUs empirically prefer to keep

patients at 4.0 mEq/L or greater, if possible.

Signs and symptoms: Weakness, cramps, cardiac arrhythmias (ST depression, QT prolongation,

flat T wave, U wave). If severe hypokalemia (e.g., serum potassium less than 2 mEq/L): flaccid

paralysis, ileus.

Etiologies:

Inadequate intake (rare; kidneys can usually adapt)

ii.

Increased losses

(a)GI fluid losses (e.g., diarrhea, fistula, drainages)
(b)Hypomagnesemia
(c)Medications (diuretics, amphotericin B, mineralocorticoid excess, cisplatin, extended-

spectrum penicillins such as piperacillin, ticarcillin)

(d)Polyuria (diabetes insipidus)
(e)Renal potassium excretion (type I/distal and type II/proximal renal tubular acidosis)
(f)Diabetic ketoacidosis

iii.

Increased requirements (building of new muscle/tissue – refeeding syndrome)

iv.

Extracellular to intracellular shift

(a)Medications (Ξ²-adrenergic agonists, including albuterol, sodium bicarbonate or other

alkalinizing agents; insulin)

(b)Acute alkalemia
(c)Hypothermia
(d)Pentobarbital
d.Treatment:

Treat, alleviate, or reduce the potential etiologies for hypokalemia, if possible.

ii.

Ensure that hypokalemia is not at least partly attributable to hypomagnesemia.

iii.

The estimated deficit should be replaced during a period of 1–3 days (depending on the extent

of deficit; the larger the deficit, the longer the repletion period) by giving boluses and increasing

the potassium content in intravenous fluids and/or PN formulation.

iv.

Enteral or oral potassium replacement is the preferred and safer route of delivery in

asymptomatic patients because of the time of absorption and feed-forward regulation of

potassium homeostasis (Ann Intern Med 2009;150:619-25); oral potassium is available in an

extended release tablet or capsule (potassium chloride), oral solution (potassium chloride), and

effervescent tablet (potassium bicarbonate); the oral solution is limited by poor palatability

(preferred for administration via nasogastric/orogastric tube), and bicarbonate salt forms

may not be appropriate for patients with a significant metabolic alkalemia; administration

of potassium chloride liquid directly into the small bowel (by a jejunal or duodenal feeding

tube) should be avoided because of its osmolality, which can lead to abdominal cramping,

distension, and diarrhea.

Central administration of intravenous repletion doses of potassium chloride or potassium

phosphate is preferred. Potassium chloride can be given at 20 mEq/hour if the patient has

continuous electrocardiography (ECG) monitoring. Ten mEq/hour is safest if the patient is

asymptomatic.

vi.

Empiric intravenous potassium dosing. Institution or ICU-specific repletion protocols are

common and may need to be adjusted according to patient body size, renal function, ongoing

losses, and response to previous boluses. The following algorithm is an example of empiric

potassium repletion that is based on serum concentrations.

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