Work

Bolus doses of insulin versus a continuous insulin infusion for treating hyperkalaemia in adults: A case series

Year: 2025

Type: article

Abstract: Hyperkalaemia is a medical emergency that may manifest with a spectrum of cardiac conduction abnormalities and, if not promptly managed, can progress to cardiac arrest. While standard management typically involves stat doses of insulin to lower serum potassium, the optimal dosing regimen remains controversial. Patients whose serum potassium exceeds the upper normal limit by more than 1 mmol/L often require repeated conventional management to shift potassium intracellularly - usually every 2 to 4 h. Although dialysis is indicated in patients with concomitant renal dysfunction, its availability in resource-constrained settings is limited. We present three cases of symptomatic hyperkalaemia successfully managed with continuous insulin infusions, thereby obviating the need for dialysis. These cases underscore the potential role of continuous insulin infusions as an alternative strategy for correcting hyperkalaemia in settings where dialysis is not immediately available.

Source: SAGE Open Medical Case Reports

DOI: 10.1177/2050313x251348368

Authors: Nicole King, Neil Martinson, Mmakwata Lesudi, Ebrahim Variava

Institutions: University of the Witwatersrand, Perinatal HIV Research Unit, Johns Hopkins University

Language: English

Topic: Potassium and Related Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000