We compared 2 similar groups of ICU patients
admitted who had normal serum levels of potassium
and creatinine at the time of admission. The patients
had a variety of medical and surgical diagnoses.
Compared with the control group, patients who
were treated empirically with a potassium supplement
added to maintenance intravenous fluid at a
rate of 72 to 144 mmol/d received significantly fewer
potassium boluses throughout their ICU stay. This
difference between the 2 groups was true for all
diagnostic categories.
Receiving fewer potassium boluses did not
affect the ICU length of stay, but it did decrease the
number of invasive procedures and the risk associated
with potassium administration. In addition,
we calculated a direct savings in material costs of
approximately $231 per patient. Most important,
because a potassium bolus is administered in response
to low serum levels of potassium, the patients in
the treatment group had significantly fewer episodes
of hypokalemia.
Limitations of our study include the lack of
random assignment of patients and data collection
for a single site. However, because of the physical
and financial benefit to patients and the decrease
in workload for health care providers, preemptive
administration of potassium to prevent episodes of
hypokalemia should be considered for patients
admitted to critical care areas who require intravenous
fluid at a rate of 75 mL/h or greater. Further
studies with a prospective design and random assignment
to allow for the generalizability of the results
are needed. Such studies may indicate a need to