Computer-guided normal-low versus normal-high potassium control after cardiac surgery: No impact on atrial fibrillation or atrial flutter - 06/02/16
, Lara Hessels b , Michiel Rienstra, MD, PhD c , Lu Yeh, MD a , Annemieke Oude Lansink, MD b , Mathijs Vogelzang, MD, PhD b , Iwan C.C. van der Horst, MD, PhD b , Joost M.A.A. van der Maaten, MD a, b , Massimo A. Mariani, MD, PhD d , Anne Marie G.A. de Smet, MD, PhD b , Michel M.R.F. Struys, MD, PhD a , Felix Zijlstra, MD, PhD e , Maarten W. Nijsten, MD, PhD b Résumé |
Introduction |
This study was designed to determine the effect of 2 different potassium regulation strategies with different targets (within the reference range) on atrial fibrillation (AF) or atrial flutter (AFL) in a cohort of intensive care unit patients after cardiac surgery.
Methods |
The GRIP-COMPASS study was a prospective double-blinded interventional study in 910 patients after cardiac surgery (coronary artery bypass grafting and/or valvular surgery). Patients were assigned to either the normal-low potassium target (nLP group, 4.0 mmol/L) or the normal-high potassium target (nHP group, 4.5 mmol/L) in alternating blocks of 50 patients. Potassium levels were regulated using a validated computer-assisted potassium replacement protocol (GRIP-II). The primary end point was the incidence of AF/AFL on a 12-lead electrocardiogram during the first postoperative week.
Results |
Of the 910 patients, 447 were assigned to the nLP group; and 463, to the nHP group, with no baseline differences between the 2 groups. The mean daily administered dose of potassium was 30 ± 23 mmol (nLP) versus 52 ± 27 mmol (nHP) (P < .001), which resulted in mean intensive care unit potassium concentration of 4.22 ± 0.36 mmol/L and 4.33 ± 0.34 mmol/L, respectively (P < .001). The incidence of AF/AFL after cardiac surgery did not differ: 38% in the nLP group and 41% in the nHP group. Also in several subgroups (eg, patients not known with prior AF/AFL or with valve surgery), there were no differences.
Conclusions |
There were no differences in incidence of AF/AFL with 2 potassium regulation strategies with different potassium targets and different amounts of potassium administered in patients after cardiac surgery.
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Vol 172
P. 45-52 - février 2016 Retour au numéro
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