1. Hypokalemia - initial diagnosis and treatment MMH A1 施孟甫

2. Lin SH et al. Am J Emerg Med 2003 (

3. Low Renin Low Aldosterone Cortisol Ectopic ACTH Cushing syndrome Liddle’sLicorice AME DOC 11  hydorxylase D 17  hydorxylase D HighNormal Low Lin SH, et al. Am J Med Sci 2003; 325: 153-156.

4. How to supply K Decrease 1 meq/L means deficient 200~400 meq K Check the Osmolarity and Acid-base status, especially DKA and acidosis will mask the K deficient condition Don’t use sugar content IVF Cl Every bottle< 20 meq KCl, except femoral line is available

5. Acid –base disorder in hypokalemia Metablic acidosis Metabolic alkalosis DKA Diuretic therapy RTA Vomiting, NG LGI loss( diarrhea, laxative abuse Mineralocorticoid excess Salt-wasing nephropathy Penicillin derivatives Liddle, Bartter, Gitelman

6. Vomiting and U Cl TimeNaKCl HCO3 - pH Day1-3 > 6.5 Late < 5.5

7. Summary Please collect urine before supplement Check Serum: Na, K, Cl, Ca, P, Mg, BUN, Cr, Osmo, Ht, Hct, ( P, 抽完先請檢驗室 離心處理檢體否則 cell lysis 會影響數據 ) Check Urine: Na, K, Cl, P, Ca, Mg, Cr, Osm, (uric acid, Urea, protein) Check Blood gas: vein is also OK 如有 elevated GOT, please check CPK We are always available !!!