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lunes, 16 de marzo de 2015

Hiperkalemia severa

PulmCrit: Pulmonary Intensivist´s Blog
PulmCrit - Posted by Josh Farkas - March 15, 2015
There is increasing recognition that sodium polystyrene sulfonate (Kayexalate) is ineffective for the immediate management of severe hyperkalemia (Kamel 2012). With Kayexalate gone, there seems to be a gap in our treatment regimen. I often encounter residents who know that Kayexalate isn't helpful, but aren't sure exactly how to treat hyperkalemia without it.
The good news is that abandoning Kayexalate allows us to focus on a more effective approach to hyperkalemia: renal potassium excretion (kaliuresis). Anyone experienced in diuresis knows that it causes a drop in the potassium level, at times requiring frequent monitoring and aggressive potassium repletion. It's time to use this to our advantage."