Acute cardiac care & resuscitation
Pharmacological interventions for the acute treatment of hyperkalaemia: A systematic review and meta-analysis
Authors' conclusion
Evidence supports treatment with insulin in combination with glucose, inhaled or intravenous sal-butamol, or the combination. No evidence supporting a clinical effect of calcium or bicarbonate for hyperkalaemia was identified.
Study context
- Population
- Patients with hyperkalaemia, with and without cardiac arreststudies included, two studies including patients with cardiac arrest
- Participants
- 101 studies
- Comparison
- Acute pharmacological interventions for the treatment of hyperkalaemia
- Outcome
- Reduction in potassium, adults without cardiac arrest (insulin in combination with glucose, inhaled salbutamol, intravenous salbutamol dissolved in glucose, or a combination)
Methodological detailsreported according to PRISMA guidelines, GRADE certainty of evidence, randomized trials, non-randomized trials, observational studies, and experimental animal studies
- Reported according to PRISMA guidelines
- GRADE certainty of evidence
- Randomized trials, non-randomized trials, observational studies, and experimental animal studies
Pooled result
As reported in the abstract
Average reduction in potassium
between 0.7 and 1.2 mmol/l
Further pooled results
Potassium levels with bicarbonate
- No effect on potassium levels
- Very low certainty of evidence
Reduction in potassium, neonatal and paediatric populations (inhaled and intravenous salbutamol)
- Average potassium reduction
- between 0.9 and 1.0 mmol/l
- Very low to low certainty of evidence
Calcium for treatment of hyperkalemia
- No evidence to support a clinical beneficial effect
Original publication
Pharmacological interventions for the acute treatment of hyperkalaemia: A systematic review and meta-analysis. Resuscitation. Published 4 January 2025. doi:10.
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