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Electrolyte Disturbances - Hypokalaemia
Electrolyte Disturbances - Hypokalaemia
Signs of Hypokalaemia
- Lethargy
- Hypotonia
- Ileus
- Weak/absent reflexes
- Poor respiratory effort
- Polyuria
ECG:
- Ventricular tachycardia
- Atrial tachycardia
- Prolonged PR
- T wave inversion
- U wave
Mild: K+>3 mmol/l
- Oral KCl replacement, 100mg/kg/day in 2-3 doses(max 1g per dose)
Moderate: K+ 2-3 mmol/l
- IV KCL 15% 1ml/200ml ½ DD,
- plus oral250mg/kg/day in 3 divided doses(max single dose 1g)
- Repeat-levels at 6 hrs if high ongoing losses
Severe: K+< 2mmol/l
- IV KCL 15% 2ml/200ml ½ DD(max infusion rate 0.5 mmol K+/kg/hr)
- plus oral 500mg/kg/day divided in 4 doses (max single dose 1g)
- Requires continuous ECG monitoring and repeated clinical assessment. Watch for respiratory failure and aggressively treat acid base disturbance. Repeat levels 4hly till K+> 2.8mmol/l.
NB Reduce dose by ½ when levels > 3mmol/l