Assessing the Impact of an Order Panel Utilizing Weight-Based Insulin and Standardized Monitoring of Blood Glucose for Patients With Hyperkalemia.

Autor:	Brown K Jr; 1 Duke University Medical Center, Durham, NC., Setji TL; 1 Duke University Medical Center, Durham, NC.; 2 Duke Regional Hospital, Durham, NC., Hale SL; 1 Duke University Medical Center, Durham, NC., Cooper A; 2 Duke Regional Hospital, Durham, NC.; 3 Campbell University, Buies Creek, NC., Hong B; 1 Duke University Medical Center, Durham, NC.; 2 Duke Regional Hospital, Durham, NC., Herbst R; 1 Duke University Medical Center, Durham, NC., Musser RC; 1 Duke University Medical Center, Durham, NC., Freeman S; 1 Duke University Medical Center, Durham, NC., Shaikewitz T; 2 Duke Regional Hospital, Durham, NC., Greenlee J; 2 Duke Regional Hospital, Durham, NC., Setji NP; 1 Duke University Medical Center, Durham, NC.
Jazyk:	angličtina
Zdroj:	American journal of medical quality : the official journal of the American College of Medical Quality [Am J Med Qual] 2018 Nov/Dec; Vol. 33 (6), pp. 598-603. Date of Electronic Publication: 2018 Mar 19.
DOI:	10.1177/1062860618764610
Abstrakt:	Intravenous insulin with glucose is used in urgent treatment for hyperkalemia but has a significant risk of hypoglycemia. The authors developed an order panel within the electronic health record system that utilizes weight-based insulin dosing and standardized blood glucose monitoring to reduce hypoglycemia. As initial evaluation of this protocol, the authors retrospectively compared potassium and blood glucose lowering in patients treated with the weight-based (0.1 units/kg) insulin order panel (n = 195) with those given insulin based on provider judgment (n = 69). Serum potassium lowering did not differ between groups and there was no relationship between dose of insulin and amount of potassium lowering. There was a difference in hypoglycemia rates between groups ( P = .049), with fewer severe hypoglycemic events in the panel (2.56%) than in the non-panel group (10.14%). These data suggest weight-based insulin dosing is equally effective for lowering serum potassium and may lower risk of severe hypoglycemia.
Databáze:	MEDLINE
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