{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:04:51Z","timestamp":1789034691941,"version":"build-2803163510"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T00:00:00Z","timestamp":1516579200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      Hypokalemia in children following cardiac surgery occurs frequently, placing them at risk of life-threatening arrhythmias. However, renal insufficiency after cardiopulmonary bypass warrants careful administration of potassium (K\n                      <jats:sup>+<\/jats:sup>\n                      ). Two different nurse-driven protocols (high dose and tiered dosing) were implemented to identify an optimal K\n                      <jats:sup>+<\/jats:sup>\n                      replacement regimen, compared to an historical low-dose protocol. Our objective was to evaluate the safety, efficacy, and timeliness of these protocols.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort review of pediatric patients placed on intravenous K\n                      <jats:sup>+<\/jats:sup>\n                      replacement protocols over 1 year was used to determine efficacy and safety of the protocols. A prospective single-blinded review of K\n                      <jats:sup>+<\/jats:sup>\n                      repletion was used to determine timeliness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Pediatric patients with congenital or acquired cardiac disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Twenty-four-bed cardiothoracic intensive care unit in a tertiary children\u2019s hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>\n                      Efficacy was defined as fewer supplemental potassium chloride (KCl) doses, as well as a higher protocol to total doses ratio per patient. Safety was defined as a lower percentage of serum K\n                      <jats:sup>+<\/jats:sup>\n                      levels \u22654.8 mEq\/L after a dose of KCl. Between-group differences were assessed by nonparametric univariate analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 138 patients with a median age of 3.0 (interquartile range: 0.23-10.0) months. The incidence of K\n                      <jats:sup>+<\/jats:sup>\n                      levels \u22654.8 mEq\/L after a protocol dose was higher in the high-dose protocol versus the tiered-dosing protocol but not different between the low-dose and tiered-dosing protocols (high dose = 2.2% vs tiered dosing = 0.5%, P = .05). The ratio of protocol doses to total doses per patient was lower in the low-dose protocol compared to the tiered-dosing protocol ( P &lt; .05). Protocol doses were administered 45 minutes faster ( P &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      The tiered-dosed, nurse-driven K\n                      <jats:sup>+<\/jats:sup>\n                      replacement protocol was associated with decreased supplemental K\n                      <jats:sup>+<\/jats:sup>\n                      doses without increased risk of hyperkalemia, administering doses faster than individually ordered doses; the protocol was effective, safe, and timely in the treatment of hypokalemia in pediatric patients after cardiac surgery.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0885066617752659","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T21:59:10Z","timestamp":1516658350000},"page":"371-377","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Safety, Efficacy, and Timeliness of Intravenous Potassium Chloride Replacement Protocols in a Pediatric Cardiothoracic Intensive Care Unit"],"prefix":"10.1177","volume":"35","author":[{"given":"Rambod","family":"Amirnovin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"},{"name":"Department of Anesthesiology Critical Care Medicine, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Cardiothoracic Intensive Care Unit, Heart Institute, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phuong","family":"Lieu","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flerida","family":"Imperial-Perez","sequence":"additional","affiliation":[{"name":"Cardiothoracic Intensive Care Unit, Heart Institute, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Taketomo","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry P.","family":"Markovitz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA"},{"name":"Department of Anesthesiology Critical Care Medicine, Children\u2019s Hospital Los Angeles, Los Angeles, CA, USA"},{"name":"Cardiothoracic Intensive Care Unit, Heart Institute, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Y.","family":"Moromisato","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cardon Children\u2019s Medical Center, Mesa, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,1,22]]},"reference":[{"key":"bibr1-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1111\/j.0954-6820.1988.tb19623.x"},{"key":"bibr2-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199911000-00018"},{"key":"bibr3-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1111\/j.1472-8206.2010.00835.x"},{"key":"bibr4-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197106172842420"},{"key":"bibr5-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1177\/0885066613491708"},{"key":"bibr6-0885066617752659","first-page":"433","volume":"92","author":"Bhatt SB","year":"1990","journal-title":"Indian J Med Res"},{"key":"bibr7-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951108002953"},{"key":"bibr8-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2009.07.014"},{"key":"bibr9-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-5153.2006.00186.x"},{"key":"bibr10-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2011.01.006"},{"issue":"3","key":"bibr11-0885066617752659","first-page":"233","volume":"18","author":"El-Sherif N","year":"2011","journal-title":"Cardiol J"},{"key":"bibr12-0885066617752659","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2005.105"},{"key":"bibr13-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2009.03.004"},{"key":"bibr14-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2009.04.032"},{"key":"bibr15-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199912000-00001"},{"key":"bibr16-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1186\/cc1068"},{"key":"bibr17-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.20.2601"},{"key":"bibr18-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010307"},{"key":"bibr19-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-10-5"},{"issue":"3","key":"bibr20-0885066617752659","first-page":"214","volume":"27","author":"Dieter RA","year":"1970","journal-title":"Rev Surg"},{"key":"bibr21-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-012-0565-4"},{"key":"bibr22-0885066617752659","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(86)90336-0"}],"container-title":["Journal of Intensive Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0885066617752659","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0885066617752659","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0885066617752659","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:55:04Z","timestamp":1777503304000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0885066617752659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,22]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1177\/0885066617752659"],"URL":"https:\/\/doi.org\/10.1177\/0885066617752659","relation":{},"ISSN":["0885-0666","1525-1489"],"issn-type":[{"value":"0885-0666","type":"print"},{"value":"1525-1489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,22]]}}}