MICU intern's survival guide hyperkalemia treatment
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Hyperkalemia Microchapters |
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Diagnosis |
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Treatment |
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Overview
Treatments based on rapidity of action
Treatment based on rapidity of action (fastest to slowest). The choice of therapy also depends on severity of ECG findings and muscle weakness.
- ====Calcium supplements====
- Calcium supplements given only in hyperkalemia with significant EKG findings.
- Calcium stabilize cardiac membranes thus antagonizing effects of potassium.
- Calcium chloride 0.5 to 1 grams (5-10 ml of 10% solution) via intravenous infusion over 2-3 minutes (central lines are preferred)
- Calcium gluconate 1 gram (10 mL of 10 % solution) infused slowly. Peripheral as well as central lines can be used.
- Repeat calcium after 5 minutes for persistent EKG changes.
- Patient should be on cardiac monitor when calcium is administered.
- Calcium can increase digoxin toxicity.
- It has a transient effect so calcium therapy should be combined with other long effect therapy.