Comparison of Enteral Versus Intravenous Potassium Supplementation (EIPS)
Acute Hypokalemia
About this trial
This is an interventional treatment trial for Acute Hypokalemia focused on measuring Hypokalemia, Intravenous, Enteral, post-cardiac surgery
Eligibility Criteria
Inclusion Criteria:
• All patients undergoing surgical repair/palliation of congenital heart lesion at the Aga Khan University Hospital and admitted to the pediatric cardiac intensive care unit (PCICU) for post-operative management.
- Serum potassium levels (<4.39 meq/l) immediate post operatively
- Patients/parents willing to participate in the study
- Have a central venous line for IVPR and an arterial line for monitoring and blood draws.
- Able to tolerate oral or nasogastric administration of medication for EPR.
Exclusion Criteria:
• Patients with acute renal failure (estimated clearance creatinine - eccr <50)
- Patients with paralytic ileus, necrotizing enterocolitis or GI bleeding.
- Patients with nausea, vomiting or diarrhea prior to randomization. Patients will not be excluded if these symptoms develop during the trial after the initial recruitment. Based on clinical decision the route of potassium supplementation may be changed if these symptoms. Intention to treat analysis will be used for the primary end point.
- Patient with symptomatic hypokalemia (manifested as a rhythm disturbances).
- Initial serum K level (post surgery) < 2.0 mEq
Sites / Locations
- CICU- Aga Khan University HospitalRecruiting
- The Aga Khan UniversityRecruiting
- The Aga Khan UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Intravenous potassium
Enteral potassium (ERP)
Patients in this arm will be administered intravenous potassium if they develop hypokalemia. As per CICU protocol 1-ml blood sample from already placed art-line or central venous line is sent for analysis of serum potassium concentration in all the immediate post operative patients. In the IVPR group, potassium will be given according to the hospital protocol through a central line. As per a previously established protocol and bioavailability data, repeat serum potassium will be sent 1 hour after replacement in the IVPR group.
Once included in the study, patients in this arm will be given oral potassium if they develop an episode of hypokalemia. As per CICU protocol 1-ml blood sample from already placed art-line or central venous line is sent for analysis of serum potassium concentration in all the immediate post operative patients. As per a previously established protocol and bioavailability data, repeat serum potassium will be sent 2 hours after replacement in the EPR group. Replacement and serum level monitoring will be done till the episode of hypokalemia is resolved