Potassium abnormalities in a pediatric intensive care unit: frequency and severity

Area of Science:

• Pediatric Critical Care Medicine
• Clinical Chemistry
• Electrolyte Balance

Background:

• Potassium abnormalities are prevalent in critically ill pediatric patients.
• This study characterizes the range of potassium level disturbances in a tertiary-level pediatric intensive care unit (PICU).

Purpose of the Study:

• To describe the spectrum of potassium abnormalities in a pediatric intensive care unit.
• To determine the incidence of hypokalemia and hyperkalemia in critically ill children.
• To investigate the association between potassium abnormalities and mortality.

Main Methods:

• Retrospective observational cohort study.
• Inclusion of all patients admitted to a single-center tertiary PICU over one year.
• Data collected from electronic medical records and laboratory results.

Main Results:

• One-third of 4484 potassium measurements were abnormal.
• Hypokalemia affected 40% of admissions; hyperkalemia affected 29%.
• Severe hypokalemia was associated with increased mortality (OR 2.2, P = .003). Hemolysis impacted 24% of hyperkalemic samples.

Conclusions:

• Mild potassium abnormalities are common in the PICU setting.
• Re-testing hemolyzed samples for hyperkalemia may be clinically useful.
• Standardized guidance for monitoring potassium levels in pediatric critical care is necessary.