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Evaluation of Care Outcomes of Patients Receiving Hyperkalemia Treatment With Insulin in Acute Care Tertiary Hospital Emergency Department

Published:October 18, 2022DOI:https://doi.org/10.1016/j.jen.2022.09.009

      Abstract

      Introduction

      Treatment of hyperkalemia using intravenous insulin can result in severe hypoglycemia, but regular blood glucose monitoring is not standardized. This study aimed to (i) explore the demographics of adult patients receiving hyperkalemia treatment and (ii) identify the incidence rate of hypoglycemia and associated demographic or clinical characteristics.

      Methods

      A descriptive design with prospective data collection was used. This study recruited 135 patients who received hyperkalemia treatment in the emergency department. Structured blood glucose monitoring was conducted at 1, 2, 4, and 6 hours after receiving intravenous insulin. Univariate analyses of association between demographic and clinical variables and hypoglycemia outcome were performed.

      Results

      There were 31 hypoglycemic events, with 11.9%, 7.4%, 2.2%, and 1.5% occurring at the 1, 2, 4, and 6 hours after treatment. The logit regression showed no significantly increased risk of hypoglycemia in terms of the demographic and clinical variables.

      Discussion

      The variation in blood glucose response observed in this study combined with the high incidences of hypolycaemia indicated the need for frequent and longer duration of monitoring for patients who were being treated for hyperkalaemia with IDT.

      Key words

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      Biography

      Siew Hoon Lim is an Assistant Nurse Clinician, Division of Nursing, Singapore General Hospital, Singapore, Singapore. ORCID identifier: http://orcid.org/0000-0002-9559-0909.

      Biography

      Siti Namira Binte Abdul Wahab is a Senior Staff Nurse, Division of Nursing, Singapore General Hospital, Singapore, Singapore.

      Biography

      Shin Yuh Ang is a Deputy Director, Division of Nursing, Singapore General Hospital, Singapore, Singapore. ORCID identifier: http://orcid.org/0000-0001-9614-7012.

      Biography

      Ming Ming Teh is a Senior Consultant Endocrinologist, Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.

      Biography

      Fazila Aloweni is a Senior Nurse Manager, Division of Nursing, Singapore General Hospital, Singapore, Singapore. ORCID identifier: http://orcid.org/0000-0001-8435-5068.