Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset

Abstract Repletion of electrolytes often depends on provider-specific behavior and hospital policy. We examined the pattern of electrolyte repletion across several intensive care units (ICU) in a large healthcare system from 2010–2015. This included 109 723 potassium repletions, 51 833 magnesium rep...

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Autores principales:	Thomas T. Joseph, Matthew DiMeglio, Annmarie Huffenberger, Krzysztof Laudanski
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/855583b3109e44f1ba26326d720acd12
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spelling	oai:doaj.org-article:855583b3109e44f1ba26326d720acd122021-12-02T15:08:26ZBehavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset10.1038/s41598-018-30444-32045-2322https://doaj.org/article/855583b3109e44f1ba26326d720acd122018-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-30444-3https://doaj.org/toc/2045-2322Abstract Repletion of electrolytes often depends on provider-specific behavior and hospital policy. We examined the pattern of electrolyte repletion across several intensive care units (ICU) in a large healthcare system from 2010–2015. This included 109 723 potassium repletions, 51 833 magnesium repletions, 2 306 calcium repletions, 8 770 phosphate repletions, and 3 128 249 visit-days over 332 018 visits. Potassium, magnesium, and calcium were usually repleted within the institutional reference range. In contrast, the bulk of phosphate repletion was done with pre-repletion serum level below the reference range. The impact of repletion on post-repletion levels was significant but uniformly small. The pre-repletion serum level had a significant inverse correlation with the post-repletion level of each electrolyte. Potassium, magnesium and phosphate follow-up labs were scheduled in 9–10 hours after their repletion. In contrast, calcium was rechecked in less than 20 minutes. Routine repletion of potassium, magnesium and calcium had no effect on the incidence of tachyarrhythmias. We estimated the expense from electrolyte repletion within the reference range was approximately $1.25 million. Absent a specific clinical indication, repleting electrolytes when the serum concentration are within normative values may represent an avenue for cost savings, staff burden unload and potential reduction in frequency of complications in the ICUs.Thomas T. JosephMatthew DiMeglioAnnmarie HuffenbergerKrzysztof LaudanskiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-9 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas T. Joseph Matthew DiMeglio Annmarie Huffenberger Krzysztof Laudanski Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset
description	Abstract Repletion of electrolytes often depends on provider-specific behavior and hospital policy. We examined the pattern of electrolyte repletion across several intensive care units (ICU) in a large healthcare system from 2010–2015. This included 109 723 potassium repletions, 51 833 magnesium repletions, 2 306 calcium repletions, 8 770 phosphate repletions, and 3 128 249 visit-days over 332 018 visits. Potassium, magnesium, and calcium were usually repleted within the institutional reference range. In contrast, the bulk of phosphate repletion was done with pre-repletion serum level below the reference range. The impact of repletion on post-repletion levels was significant but uniformly small. The pre-repletion serum level had a significant inverse correlation with the post-repletion level of each electrolyte. Potassium, magnesium and phosphate follow-up labs were scheduled in 9–10 hours after their repletion. In contrast, calcium was rechecked in less than 20 minutes. Routine repletion of potassium, magnesium and calcium had no effect on the incidence of tachyarrhythmias. We estimated the expense from electrolyte repletion within the reference range was approximately $1.25 million. Absent a specific clinical indication, repleting electrolytes when the serum concentration are within normative values may represent an avenue for cost savings, staff burden unload and potential reduction in frequency of complications in the ICUs.
format	article
author	Thomas T. Joseph Matthew DiMeglio Annmarie Huffenberger Krzysztof Laudanski
author_facet	Thomas T. Joseph Matthew DiMeglio Annmarie Huffenberger Krzysztof Laudanski
author_sort	Thomas T. Joseph
title	Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset
title_short	Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset
title_full	Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset
title_fullStr	Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset
title_full_unstemmed	Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset
title_sort	behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/855583b3109e44f1ba26326d720acd12
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Behavioural patterns of electrolyte repletion in intensive care units: lessons from a large electronic dataset

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