Pediatric emergency medicine trisk 2860 2860
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (99.43 KB, 1 trang )
TABLE 100.7
CAUSES OF HYPOKALEMIA
Decreased potassium intake
Increased renal excretion
Diuretics
Metabolic alkalosis (chloride deficient)
Diabetic ketoacidosis
Increased mineralocorticoid effect
Nonreabsorbable anions
Renal tubular acidosis (type 1 and type 2)
Bartter syndrome
Gitelman syndrome
Magnesium depletion
Increased gastrointestinal losses
Diarrhea
Laxatives
Ostomy losses
Increased cellular uptake (redistributive)
Acute alkalosis
Insulin therapy
Elevated β-adrenergic activity
Increase in bone marrow cell production
Hypokalemic periodic paralysis
Potassium homeostasis is complex and dynamic in the setting of DKA
(see Chapter 89 Endocrine Emergencies ). Since their urinary losses of
potassium are high, patients with DKA generally have total body potassium
depletion at presentation. However, the combination of insulin deficiency,
hyperosmolality, and acidosis may result in normal or elevated serum
potassium at presentation. Hypokalemia in a child who presents with DKA
would suggest significant potassium depletion and need for
supplementation with close monitoring.
The cause of hypokalemia may be inferred after a careful history is
obtained. This should include a thorough account of medications taken,
