Insulin Dextrose Infusion vs Nebulized Salbutamol vs Combination of Salbutamol and Insulin Dextrose in Acute Hyperkalemia
Status:
Recruiting
Trial end date:
2022-06-20
Target enrollment:
Participant gender:
Summary
Hyperkalemia is a common electrolyte disorder, especially among patients with chronic kidney
disease, diabetes mellitus, or heart failure. Globally, the reported incidence of
hyperkalemia varies from 1.1 to 10 per 100 hospitalizations, depending on the patient cohort
and comorbidities. Hyperkalemia is a potentially life-threatening electrolyte disturbance
that can be fatal if left untreated. Several studies have established the association between
hyperkalemia and all-cause mortality. Because of the deleterious cardiac effects of
hyperkalemia, its management is an emergency intervention. However, robust evidence is
lacking to guide the emergency management of patients with hyperkalemia. Emergency treatment
approaches are largely based on small studies, anecdotal experience, and traditionally
accepted practice patterns within institutions. Therefore, a rigorous evaluation of the
first-line treatments of hyperkalemia in emergency departments is needed and a large scale
randomized clinical trial is warranted before robust recommendations for clinical practice
can be made. Our clinical trial will improve the safety of patients with acute hyperkalemia
and will help clinicians in their day by day practice to choose the treatment that
significantly reduces morbidity and mortality during acute hyperkalemia management. Our
results will be delivered in a timely fashion, owing to the high prevalence of hyperkalemia
in the emergency department setting and to the commitment of the INI-CRCT network of
Excellence, along with ED specialists used to work jointly.
the primary objective of our trial is to compare insulin/dextrose intravenous infusion,
nebulized salbutamol or combination of nebulized salbutamol and insulin/dextrose intravenous
infusion to reduce serum potassium concentration at 60 minutes, as first-line treatment, in
emergency departments.