JEM reports最新文献_第3页

Rescuing the heart: HIET in undifferentiated shock from beta-blocker and dapagliflozin overdose in acute coronary syndrome 抢救心脏：急性冠状动脉综合征患者过量服用β受体阻滞剂和达格列净导致的未分化性休克中的HIET

JEM reports Pub Date : 2025-02-14 DOI: 10.1016/j.jemrpt.2025.100152

Arihant Jain , Swetha Ramesh , Shruti Singh , Anas Mohammed Muthanikkatt , N. Balamurugan

{"title":"Rescuing the heart: HIET in undifferentiated shock from beta-blocker and dapagliflozin overdose in acute coronary syndrome","authors":"Arihant Jain , Swetha Ramesh , Shruti Singh , Anas Mohammed Muthanikkatt , N. Balamurugan","doi":"10.1016/j.jemrpt.2025.100152","DOIUrl":"10.1016/j.jemrpt.2025.100152","url":null,"abstract":"<div><h3>Background</h3><div>A 60-year-old female with ischemic dilated cardiomyopathy and diabetes mellitus presented with acute coronary syndrome (ACS) complicated by severe ventricular tachyarrhythmia after ingesting an excessive dose of metoprolol (250 mg) and dapagliflozin (100 mg). Despite metoprolol's dose being below traditional toxic thresholds, chronic beta-blocker therapy likely amplified its negative inotropic effects, leading to refractory hypotension overdose of metoprolol was not the cause of V tach, rather it was because of underlying ACS. Initial resuscitation with synchronized cardioversion and noradrenaline infusion failed to stabilize her blood pressure. High-Dose Insulin Euglycemia Therapy (HIET) was initiated as a salvage measure, resulting in significant hemodynamic improvement within 2–3 hours, increased left ventricular ejection fraction (LVEF) on repeat echocardiography, and blood pressure stabilization.</div></div><div><h3>Case-report</h3><div>The patient presented with severe ventricular tachyarrhythmia and persistent hypotension following an overdose of metoprolol and dapagliflozin. Despite initial treatments, her condition did not improve. HIET was initiated and led to rapid hemodynamic stabilization and improved LVEF within a few hours. Lidocaine infusion was added to manage the prolonged QT interval and suppress further arrhythmias. Her condition gradually improved over the following days, with resolution of hypotension and arrhythmias. She was discharged after four days of inpatient care.</div></div><div><h3>Why should an emergency physician be aware of this ?</h3><div>This case highlights that chronic beta-blocker use can lead to refractory hypotension even at non-toxic overdose levels and demonstrates the efficacy of HIET as a critical, lifesaving intervention for shock and cardiac recovery in overdose of B- blocker.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Compressive neuropathy following intermittent pneumatic compression device: A case report 间歇性气动压缩装置后压缩性神经病变1例报告

JEM reports Pub Date : 2025-02-10 DOI: 10.1016/j.jemrpt.2025.100150

Tyler D'Ovidio , Abhishek Mogili , Simeret Genet , Charles R. Litchfield , Rachel E. Solnick

{"title":"Compressive neuropathy following intermittent pneumatic compression device: A case report","authors":"Tyler D'Ovidio , Abhishek Mogili , Simeret Genet , Charles R. Litchfield , Rachel E. Solnick","doi":"10.1016/j.jemrpt.2025.100150","DOIUrl":"10.1016/j.jemrpt.2025.100150","url":null,"abstract":"<div><h3>Background</h3><div>Compression neuropathy is a relatively common neurological condition that affects many individuals. Common etiologies include tight clothing, trauma, overuse, and obesity; however, iatrogenic causes such as improper positioning during surgical procedures are not commonly reported.</div></div><div><h3>Case report</h3><div>We present a case of a 57-year-old female who presented to the emergency department (ED) with posterior left calf and foot sensory loss with gait instability. She recently underwent surgery, during which she recalled having a tight and uncomfortable intermittent pneumatic compression device placed on her left calf. Her workup was largely unremarkable and supported the diagnosis of peripheral nerve compression, most likely of tibial origin.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Peripheral neuropathies are common causes of ED presentations and have a wide variety of etiologies. One less common factor that emergency physicians should consider is recent surgery during which an intermittent pneumatic compression device (IPCD) was used.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

3D-augmentation of 2D ultrasound for appendicitis diagnosis: A cross-sectional pilot study 三维增强二维超声诊断阑尾炎：横断面试点研究

JEM reports Pub Date : 2025-02-01 DOI: 10.1016/j.jemrpt.2025.100149

Rebecca G. Theophanous , Elias Jaffa , Matthew R. Morgan , Carl D. Herickhoff , Erica Peethumnongsin , Joao Ricardo Nickenig Vissoci , Joshua S. Broder

{"title":"3D-augmentation of 2D ultrasound for appendicitis diagnosis: A cross-sectional pilot study","authors":"Rebecca G. Theophanous , Elias Jaffa , Matthew R. Morgan , Carl D. Herickhoff , Erica Peethumnongsin , Joao Ricardo Nickenig Vissoci , Joshua S. Broder","doi":"10.1016/j.jemrpt.2025.100149","DOIUrl":"10.1016/j.jemrpt.2025.100149","url":null,"abstract":"<div><h3>Background</h3><div>Two-dimensional ultrasound (2DUS) is first-line imaging for pediatric appendicitis but is often nondiagnostic. Computed tomography (CT) is expensive with ionizing radiation. Three-dimensional ultrasound (3DUS) can capture multiplanar images using volume acquisition without radiation exposure.</div></div><div><h3>Objective</h3><div>We hypothesized that bedside-performed 3DUS would be feasible, with rapid image acquisition times, and good image quality comparable to 2DUS and CT.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional pilot study on emergency department patients being evaluated for appendicitis. An emergency physician captured 3DUS images using a Sonosite M-Turbo machine equipped with an inertial measurement unit and customized software. Our primary outcome was 3DUS acquisition times compared to 2DUS and CT. Secondary outcomes were 3DUS image quality, with visual demonstrations of appendicitis findings compared to clinical imaging.</div></div><div><h3>Results</h3><div>20 subjects underwent an experimental 3DUS between October 2015 and March 2017. Mean age was 11.6 years (4.6–30.4 years). Five patients (25 %) had clinical appendicitis (2 by 2DUS and 3 by CT). Mean 3DUS acquisition and reconstruction times were 10.3 and 14.5 s, compared to 2DUS (41 min) and CT (22 min). Mean 3DUS pixels were 320.5 PPI depth, 388 PPI width, mean total frame number 344, and field of view 78.8°. Finally, we demonstrated two appendicitis complications on 3DUS: abscess and a dilated noncompressible appendix with appendicoliths.</div></div><div><h3>Conclusion</h3><div>Our study suggests 3DUS is fast with good image quality. We presented 3DUS images of acute appendicitis comparable to 2DUS and CT as visual demonstrations of feasibility. Future studies with larger cohorts are needed to assess diagnostic accuracy.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143308002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Re-presentations to the emergency department initial presentation with COVID-19: Insights from the omicron wave 向急诊科重新介绍COVID-19的初步介绍：来自欧米波的见解

JEM reports Pub Date : 2025-01-31 DOI: 10.1016/j.jemrpt.2025.100147

Daniella Audish , George Braitberg , Anselm Wong

{"title":"Re-presentations to the emergency department initial presentation with COVID-19: Insights from the omicron wave","authors":"Daniella Audish , George Braitberg , Anselm Wong","doi":"10.1016/j.jemrpt.2025.100147","DOIUrl":"10.1016/j.jemrpt.2025.100147","url":null,"abstract":"<div><h3>Background</h3><div>Relapsing symptoms post-SARS-CoV-2 (COVID) infection, particularly with variants like Omicron, remain poorly understood and cumulative mortality rates are in the millions worldwide. Re-presentation rates to emergency departments (ED) post initial presentation are poorly defined.</div></div><div><h3>Objectives</h3><div>To identify the frequency and characteristics of ED re-presentations during the six months post initial COVID-19 admission.</div></div><div><h3>Methodology</h3><div>A retrospective chart review of patients with a positive COVID-19 PCR result <em>and</em> initial ED presentation at the Austin hospital in Victoria, Australia during January–February 2022 (wave one) and March–April 2022 (wave two). Subsequent ED re-presentations up to six months from initial admission were analyzed, concentrating on symptoms, diagnoses and mortalities.</div></div><div><h3>Results</h3><div>Of 926 wave one patients meeting the inclusion criteria, 162 (18 %) had subsequent ED presentations. For wave two, out of 556 patients, 129 (23 %) had re-presentations. The highest number of re-presentations for an individual were 24 and 11 for waves one and two respectively. Shortness of breath was the most common symptom for re-presentation during both waves (21 % and 19 % respectively), followed by cough. Additionally, 79 % of wave one patients and 29 % of wave two patients had respiratory-related comorbidities. Twelve percent of patients died within six months of the initial COVID-19 related presentation in wave one compared to 7 % in wave two.</div></div><div><h3>Conclusion</h3><div>Re-presentation rates were similar to previous COVID waves with the alpha and delta variants. Respiratory symptoms and related diagnoses were common. Strengthening public health strategies is vital to curb transmission, alleviate strain on hospitals, and prevent further morbidity and mortality.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early-stage balanitis xerotica obliterans in an 11-year-old boy 11岁男童早期完全性干性龟头炎

JEM reports Pub Date : 2025-01-28 DOI: 10.1016/j.jemrpt.2025.100148

Shaili Patel , Ee Tein Tay

引用次数: 0

An atypical case of infective endocarditis initially diagnosed as myopericarditis 一例不典型的感染性心内膜炎，最初诊断为心包炎

JEM reports Pub Date : 2025-01-27 DOI: 10.1016/j.jemrpt.2025.100145

Negin Ceraolo , Rachel Dietz , Spencer Prete , Erin L Simon

{"title":"An atypical case of infective endocarditis initially diagnosed as myopericarditis","authors":"Negin Ceraolo , Rachel Dietz , Spencer Prete , Erin L Simon","doi":"10.1016/j.jemrpt.2025.100145","DOIUrl":"10.1016/j.jemrpt.2025.100145","url":null,"abstract":"<div><h3>Background</h3><div>Acute myopericarditis is inflammation of the pericardium, or the membrane surrounding the heart, and the myocardium, or the muscular myocardial layer of the heart. Infective endocarditis is an infection of the cardiac endothelium. Diagnosis relies on clinical evaluation, blood cultures to identify the causative organism, and echocardiography to visualize vegetations on heart valves. In the emergency department (ED), distinguishing between myopericarditis and infective endocarditis is crucial to avoid misdiagnosis.</div></div><div><h3>Case report</h3><div>We present the case of a 36-year-old male who was initially hospitalized for myocarditis and discharged on medications with cardiology follow-up planned. Twelve days later, the patient was readmitted with recurring chest pain. A bedside cardiac ultrasound showed mild mitral regurgitation. The patient was found to have bacteremia with Streptococcus anginosus which was concerning for endocarditis. The patient was transferred to a quaternary care hospital, where he underwent successful mitral valve repair.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>In the ED setting, it is crucial to broaden differential diagnoses. Myopericarditis can sometimes result from endocarditis, which can present in various ways. Therefore, endocarditis should be ruled out in acute presentations of chest pain. To avoid missing cases of endocarditis, obtaining blood cultures from patients with myopericarditis symptoms is essential. Additionally, expediting a transesophageal echocardiogram (TEE) can lead to a faster and more accurate diagnosis. Promptly conducting these tests can reduce the number of missed endocarditis cases and prevent patients from returning to the emergency department.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Angiotensin converting enzyme inhibitor-induced penile angioedema: A case report 血管紧张素转换酶抑制剂诱导阴茎血管性水肿1例

JEM reports Pub Date : 2025-01-27 DOI: 10.1016/j.jemrpt.2025.100143

Anthony Acosta , Enas Alamreia , Nimra Afreen , Zane Elfessi

{"title":"Angiotensin converting enzyme inhibitor-induced penile angioedema: A case report","authors":"Anthony Acosta , Enas Alamreia , Nimra Afreen , Zane Elfessi","doi":"10.1016/j.jemrpt.2025.100143","DOIUrl":"10.1016/j.jemrpt.2025.100143","url":null,"abstract":"<div><h3>Background</h3><div>Angioedema is local swelling in the subcutaneous or submucosal layers resulting from bradykinin-mediated capillary leakage allowing fluid to accumulating in the interstitial space. It is estimated to affect up to 1 in 10,000 individuals each year worldwide.</div></div><div><h3>Case report</h3><div>Angioedema typically affects areas such as the face, lips, mouth, and throat, larynx, uvula, and GI tract, but rarely affects the genitals. Causes of angioedema include allergic reactions, drug-induced, hereditary factors, acquired factors, and idiopathic. We report a rare case of penile angioedema due to the angiotensin-converting enzyme (ACE) inhibitor lisinopril.</div><div>Why should an EM Physician be aware of this?</div><div>Penile angioedema is an extremely rare complication of ACE inhibitor use and should be included in the differential diagnosis for genital swelling. In the absence of complications from angioedema, such as paraphimosis, patients can be discharged from the emergency department without the need for pharmacotherapy as the swelling is self-resolving after discontinuation of the offending agent.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilateral true vocal fold avulsion following trampoline accident: A case report 蹦床事故致双侧真声带撕脱1例

JEM reports Pub Date : 2025-01-27 DOI: 10.1016/j.jemrpt.2025.100146

Allison Epstein , Alexandra Welschmeyer , Temitope Adeyeni , Jamil Hayden , Matthew Gropler , Jay Shah , Nelson Scott Howard

{"title":"Bilateral true vocal fold avulsion following trampoline accident: A case report","authors":"Allison Epstein , Alexandra Welschmeyer , Temitope Adeyeni , Jamil Hayden , Matthew Gropler , Jay Shah , Nelson Scott Howard","doi":"10.1016/j.jemrpt.2025.100146","DOIUrl":"10.1016/j.jemrpt.2025.100146","url":null,"abstract":"<div><h3>Background</h3><div>Vocal cord avulsion is a rare and potentially devastating injury which may result from blunt laryngotracheal trauma. While there are cases of unilateral vocal cord avulsion, we present a pediatric patient with bilateral vocal cord avulsion from blunt trauma to the anterior neck following a trampoline accident.</div></div><div><h3>Case report</h3><div>This 10-year-old female presented with dysphonia and dysphagia and was found to have bilateral vocal cord avulsion effecting the superior vocal fold with a noticeable height mismatch and exposed cartilage seen only on diagnostic direct laryngoscopy, corresponding to a Schaeffer Grade 3 laryngeal injury. Distal chip laryngoscopy was not as useful in providing a comprehensive examination of the patient due to muscle tension with arytenoid prolapse. Primary endoscopic repair was performed with subsequent improved vocal cord position, voice quality, and tolerance of oral intake.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Laryngeal trauma in children is rare, and early detection is critical to optimize long term outcomes. To date, no universal protocol for diagnosis and management of these injuries in the pediatric population exists. A low index of suspicion of endolaryngeal injury must be maintained for children with these injuries given their smaller airway diameter and increased propensity to develop acute airway compromise in the absence of obvious warning signs or symptoms. We highlight our endoscopic repair technique and excellent postoperative course with improvements in voice, swallow, and overall quality of life.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100146"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unveiling Wunderlich syndrome: Diagnosis and management of a rare spontaneous renal hematoma 揭示Wunderlich综合征：罕见自发性肾血肿的诊断和治疗

JEM reports Pub Date : 2025-01-27 DOI: 10.1016/j.jemrpt.2025.100144

Rebecca Merrill , Pete Jordanides , Jessica Krizo , Erin L. Simon

{"title":"Unveiling Wunderlich syndrome: Diagnosis and management of a rare spontaneous renal hematoma","authors":"Rebecca Merrill , Pete Jordanides , Jessica Krizo , Erin L. Simon","doi":"10.1016/j.jemrpt.2025.100144","DOIUrl":"10.1016/j.jemrpt.2025.100144","url":null,"abstract":"<div><h3>Background</h3><div>Wunderlich syndrome (WS) is a rare condition that is described as an atraumatic, spontaneous renal hemorrhage in the perirenal space. Symptoms typically present as nondescript flank pain, but a flank mass and hypovolemic shock are also possible. Computed tomography (CT) imaging with intravenous contrast should be the modality of choice to diagnose WS, with recent studies highlighting the efficacy of transcatheter arterial embolization (TAE) as the preferred treatment over surgery. WS is often secondary to conditions such as renal neoplasms, vascular diseases, and infections, necessitating adequate follow up to determine the etiology.</div></div><div><h3>Case report</h3><div>We present the case of a 79-year-old woman presenting to the emergency department (ED) with left flank pain. Computed tomography with angiography revealed a large left renal subcapsular hematoma with perinephric and retroperitoneal extension with active extravasation, characteristic of Wunderlich syndrome. The patient was treated emergently with transcatheter arterial embolization of the lower polar branch of her left renal artery. In the ED, WS can present with a variety of non-specific symptoms, making the diagnosis challenging for emergency physicians.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Wunderlich syndrome is a rare, sudden, and life-threatening emergency that requires prompt diagnosis, as the hematoma can spread to the perinephric space leading to massive internal hemorrhage. Causes and presenting symptoms are variable, with flank pain being a common symptom. CT or MRI imaging is necessary for diagnosis, and embolization is often the treatment of choice to avoid further complications.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypoglycaemia and monitoring practices following insulin-dextrose therapy for hyperkalaemia 胰岛素-葡萄糖治疗高钾血症后的低血糖和监测实践

JEM reports Pub Date : 2025-01-25 DOI: 10.1016/j.jemrpt.2025.100142

Samuel Ford , Julian Williams , Ian Coombes , Adam La Caze

{"title":"Hypoglycaemia and monitoring practices following insulin-dextrose therapy for hyperkalaemia","authors":"Samuel Ford , Julian Williams , Ian Coombes , Adam La Caze","doi":"10.1016/j.jemrpt.2025.100142","DOIUrl":"10.1016/j.jemrpt.2025.100142","url":null,"abstract":"<div><h3>Background</h3><div>Hypoglycaemia is commonly encountered following insulin-dextrose therapy (IDT) for hyperkalaemia. This retrospective study aimed to assess the local incidence of hypoglycaemia following IDT for hyperkalaemia in the Emergency Department (ED).</div></div><div><h3>Objectives</h3><div>Describe the local incidence of hypoglycaemia and BGL monitoring practices following IDT for hyperkalaemia in the ED.</div></div><div><h3>Methods</h3><div>Adult patients with hyperkalaemia (>5.5 mmol/L) who received IDT in a large metropolitan ED were included. The primary outcome was the incidence of hypoglycaemia, defined as a BGL less than 70 mg/dL (3.9 mmol/L), within 5 h post-administration. Secondary outcomes included hypoglycaemia severity, time to hypoglycaemia, risk factors for hypoglycaemia, blood glucose and potassium monitoring. Data collection spanned January 1, 2019 to May 1, 2020.</div></div><div><h3>Results</h3><div>Among 90 patients, 51 % were receiving chronic renal replacement therapies and the incidence of hypoglycaemia and severe hypoglycaemia was 30 % and 6.7 % respectively. Risk factors for hypoglycaemia were lower pre-treatment blood glucose (p=<0.001), absence of diabetes (p=<0.001) and not being prescribed insulin prior to presentation (p = 0.0026). Approximately 50 % of patients received ≤2 blood glucose measurements within 5 h post IDT. Only 44 % of patients had a potassium sample taken in the 1st hour post IDT and 24 % in hour 3.</div></div><div><h3>Conclusions</h3><div>This study demonstrates a higher incidence of hypoglycaemia post-IDT for hyperkalaemia than reported in the general population and estimates the incidence of severe hypoglycaemia in an Australian population. Monitoring of both blood glucose levels (BGL) and potassium was suboptimal. Strategies to improve BGL monitoring and prospective studies to define the optimal dose of insulin-glucose for hyperkalaemia are needed.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0