*3.1.4 Treatment*


• Treatment options include reviewing medication that can cause hyperkalemia, reduction in dietary potassium intake and start medication that can increase

• Sodium zirconium cyclosilicate (Lokelma) should not be used for the acute management of hyperkalemia due to delayed onset of action. Onset of action is 1-6 hours with duration possibly 4-12 hours. Sodium polystyrene sulfonate (Kayexalate) has a high sodium load, and its time of onset is variable making it

• Hypokalemia is a common electrolyte disorder defined as potassium <3.5 mEq/L (mmol/L) and can be life threatening if serum potassium <2.5 mEq/L (mmol/L). A vast majority of potassium is located intracellularly therefore hypokalemia is often due to a large total body potassium deficit [33].

exponentially larger decrease in the total body potassium deficit.

1.Mild Hypokalemia: - Serum Potassium 3-3.4 mEq/L (mmol/L)

3. Severe Hypokalemia: - Serum Potassium <2.5 mEq/L (mmol/L)

• Clinical features usually occur when serum potassium<2.5 mEq/L (mmol/L) and includes muscle pain, cramps, weakness, fatigue, constipation, syncope

• Hypokalemia can be caused by excessive potassium loss, inadequate intake or a

3.Presence of U wave (giant U waves may be mistaken for peaked T waves)

• Inadequate potassium intake is a rare cause of hypokalemia and in most cases, dietary restrictions exacerbate hypokalemia due to other causes (see **Figure 7**) [33].

• EKG changes associated with hypokalemia are (see EKG 2) [33]:

2.Moderate Hypokalemia: - Serum Potassium 2.5-2.9 mEq/L (mmol/L)

• Based on serum potassium, hypokalemia can be classified into:

• The relationship between potassium level and total body potassium deficit is exponential; as the potassium level falls progressively lower, this represents an

potassium excretion.

*DOI: http://dx.doi.org/10.5772/intechopen.96957*

and palpitations [33, 34].

transcellular shift of potassium.

1.Decreased T wave amplitude

2. ST-segment depression

*3.2.2 Diagnostic approach*

*3.2.3 EKG changes*

**147**

**3.2 Hypokalemia**

*Electrolytes in the ICU*

*3.2.1 Introduction*

a poor choice for acute management.

**Figure 5.** *Steps of acute management of hyperkalemia.*


**Figure 6.** *Continued treatment of hyperkalemia.*

