Table 5 Studies on potassium balance and supplementation

Morris et al. [14]

RCT

120.4 mmol

Insulin 0.3 U/kg (IV + IM),

No difference in serum K decline

Ann Intern Med 1986

Adults (N = 21)

(mean)

then IM 7 U/hr

Gamba et al. [15]

RCT

84 mmol

IV insulin 5 U/hr

Lower serum K at 24 hr for bicarb arm vs. control,

Rev Cl In 1991

Adults (N = 20)

(mean)

p < 0.05

BUT trend for more K given in control

Soler et al. [22]

Prospective

Grp 1: none

Grp 1: 234 U/24 hr

More K requirement over 24 hr for Grp 3

Lancet 1972

Mixed (N = 25)

Grp 2: 200 mmol

Grp 2: 287 U/24 hr

Estimated 30 mmol/L of K needed for Grps 1 & 2,

(3-arm study; age 13-84 yr)

Grp 3: 400 mmol

Grp 3: 288 U/24 hr

& 40 mmol/L for Grp 3

only 2 groups randomized

(per L of fluid infused)

Lutterman et al. [17]

Retrospective

167 mmol

High-dose insulin (mean

No difference in mean serum K

Diabetologia 1979

Adults (N = 24)

(standard)

260 ± 60 U in 1st 6 hr)

No difference in K requirement over 12 hrs

vs. low dose 8 U/hr

Lever et al. [18]

Retrospective

130-135 mmol

IM or IV insulin

No difference in K requirement

Am J Med 1983

Adults (N = 73)

(standard)

5-6 U/hr (for all)

6 hypokalemia (< 3.3 mmol/L) in bicarb arm, 1 in control

Viallon et al. [20]

Retrospective

120 ± 40 mmol

IV insulin for all

More K requirement over 24 hr for bicarb arm,

Crit Care Med 1999

Adults (N = 39)

(mean)

(dose unspecified)

p < 0.001

1 hypokalemia (< 3 mmol/L) in bicarb arm

Green et al. [24]

Retrospective

2.08 mmol/kg

IV insulin for all

No difference in hypokalemia occurrence

Ann Emerg Med 1998

Pediatrics (N = 106)

(mean)

(dose unspecified)