Potassium abnormalities in a pediatric intensive care unit: frequency and severity

J Intensive Care Med. 2014 Sep-Oct;29(5):269-74. doi: 10.1177/0885066613491708. Epub 2013 Jun 6.


Background: Potassium abnormalities are common in critically ill patients. We describe the spectrum of potassium abnormalities in our tertiary-level pediatric intensive care unit (PICU).

Methods: Retrospective observational cohort of all the patients admitted to a single-center tertiary PICU over a 1-year period. Medical records and laboratory results were obtained through a central electronic data repository.

Results: A total of 512 patients had a potassium measurement. Of a total of 4484 potassium measurements, one-third had abnormal values. Hypokalemia affected 40% of the admissions. Mild hypokalemia (3-3.4 mmol/L) affected 24% of the admissions. Moderate or severe hypokalemia (K <3.0 mmol/L) affected 16% of the admissions. Hyperkalemia affected 29% of the admissions. Mild hyperkalemia (5.1-6.0 mmol/L) affected 17% of the admissions. Moderate or severe hyperkalemia (>6.0 mmol/L) affected 12%. Hemolysis affected 2% of all the samples and 24% of hyperkalemic values. On univariate analysis, severity of hypokalemia was associated with mortality (odds ratio 2.2, P = .003).

Conclusions: Mild potassium abnormalities are common in the PICU. Repeating hemolyzed hyperkalemic samples may be beneficial. Guidance in monitoring frequencies of potassium abnormalities in pediatric critical care is needed.

Keywords: hemolysis; hyperkalemia; hypokalemia; intensive care units; pediatric.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Boston / epidemiology
  • Child
  • Child, Preschool
  • Critical Illness*
  • Female
  • Humans
  • Hyperkalemia / epidemiology*
  • Hypokalemia / epidemiology*
  • Infant
  • Intensive Care Units, Pediatric*
  • Length of Stay / statistics & numerical data
  • Male
  • Retrospective Studies
  • Severity of Illness Index