Bolus doses of insulin versus a continuous insulin infusion for treating hyperkalaemia in adults: A case series

Hyperkalaemia is a medical emergency that may manifest with a spectrum of cardiac conduction abnormalities and, if not promptly managed, can progress to cardiac arrest. While standard management typically involves stat doses of insulin to lower serum potassium, the optimal dosing regimen remains con...

Full description

Saved in:
Bibliographic Details
Main Authors: Nicole King, Neil Martinson, Mmakwata Lesudi, Ebrahim Variava
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X251348368
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Hyperkalaemia is a medical emergency that may manifest with a spectrum of cardiac conduction abnormalities and, if not promptly managed, can progress to cardiac arrest. While standard management typically involves stat doses of insulin to lower serum potassium, the optimal dosing regimen remains controversial. Patients whose serum potassium exceeds the upper normal limit by more than 1 mmol/L often require repeated conventional management to shift potassium intracellularly – usually every 2 to 4 h. Although dialysis is indicated in patients with concomitant renal dysfunction, its availability in resource-constrained settings is limited. We present three cases of symptomatic hyperkalaemia successfully managed with continuous insulin infusions, thereby obviating the need for dialysis. These cases underscore the potential role of continuous insulin infusions as an alternative strategy for correcting hyperkalaemia in settings where dialysis is not immediately available.
ISSN:2050-313X