Maintenance of Serum Potassium Levels ≥3.6 mEq/L Versus ≥4.5 mEq/L After Isolated Elective Coronary Artery Bypass Grafting and the Incidence of New-Onset Atrial Fibrillation: Pilot and Feasibility Study Results.
J Cardiothorac Vasc Anesth
; 36(3): 847-854, 2022 03.
Article
in En
| MEDLINE
| ID: mdl-34404592
ABSTRACT
OBJECTIVE:
Serum potassium levels frequently are maintained at high levels (≥4.5 mEq/L) to prevent atrial fibrillation after cardiac surgery (AFACS), with limited evidence. Before undertaking a noninferiority randomized controlled trial to investigate the noninferiority of maintaining levels ≥3.6 mEq/L compared with this strategy, the authors wanted to assess the feasibility, acceptability, and safety of recruiting for such a trial.DESIGN:
Pilot and feasibility study of full trial protocol.SETTING:
Two university tertiary-care hospitals.PARTICIPANTS:
A total of 160 individuals undergoing first-time elective isolated coronary artery bypass grafting.INTERVENTIONS:
Randomization (11) to protocols aiming to maintain serum potassium at either ≥3.6 mEq/L or ≥4.5 mEq/L after arrival in the postoperative care facility and for 120 hours or until discharge from the hospital or AFACS occurred, whichever happened first. MEASUREMENTS AND MAINRESULTS:
Primaryoutcomes:
(1) whether it was possible to recruit and randomize 160 patients for six months (estimated 20% of those eligible); (2) maintaining supplementation protocol violation rate ≤10% (defined as potassium supplementation being inappropriately administered or withheld according to treatment allocation after a serum potassium measurement); and (3) retaining 28-day follow-up rates ≥90% after surgery. Between August 2017 and April 2018, 723 patients were screened and 160 (22%) were recruited. Potassium protocol violation rate = 9.8%. Follow-up rate at 28 days = 94.3%. Data on planned outcomes for the full trial also were collected.CONCLUSIONS:
It is feasible to recruit and randomize patients to a study assessing the impact of maintaining serum potassium concentrations at either ≥3.6 mEq/L or ≥4.5 mEq/L on the incidence of AFACS.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Atrial Fibrillation
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
J Cardiothorac Vasc Anesth
Year:
2022
Type:
Article