Grade Insurance
The article I chose for my grade insurance paper is “Albuterol and Insulin therapy in hemodialysis patients. http://www.nature.com/ki/journal/v38/n5/index.html. The reason I chose this article is because we have been going over potassium and action potential in class I have been extremely interested in potassium, part of this is because hyperkalemia is one of the few electrolyte imbalances we can start treatment for in a pre-hospital setting. The article was very informative and allowed me a new learning opportunity, it was fun to learn that some of the physiological process behind the treatment of hyperkalemia expanded into other physiological process such as glucose management and metabolic cycles. The hypothesis for this case study is that the combination of albuterol and insulin to control blood potassium is an additive effect. The control groups in this experiment were the patients given just albuterol, or just insulin, the variable was the patients given a combination of albuterol and insulin. Although this case study was done thoroughly and had several other studies supporting its findings, the case study its self was rather small only including 12 people with only 10 participants finishing the study. In the study the effects of albuterol, insulin with D50, and a combination of albuterol and insulin with 50ml of a 50% dextrose solution (D50) were administered to patients on hemodialysis. …show more content…
Patients were then monitored and tested for changes in Plasma blood glucose (pbg) and Potassium levels in the blood. The case study was small including only 12 patients broken up into 3 groups of 4, none of which were diabetics with ages ranging from 34-72, 2 of the patients in the study were removed. The patients were administered either 10 units of insulin and D50, or 20mg of albuterol in 4ml of normal saline (ns) over the course of 10 minutes, or patients were administered a combination of insulin and D50 as well as albuterol. The patients were then monitored for 1 hour with potassium and PBG being assessed every 15mins. All of the patients in the trial were not on beta blockers and had roughly the same lab values at the start of the trial, plasma blood glucose levels around 4.7 millimols per liter and blood potassium levels between 5.48-5.89 millimols per liter. The results of the case study were gathered by using heparinized tubes and a centrifuge immediately. Plasma potassium levels were analyzed using flame photometry (uses flame and flame color to measure concentration of alkali metals in a substance.), blood glucose was analyzed using a Beckman analyzer, and blood insulin levels were measured using radioimmunoassay (uses radioactive antigens to measure concentration of hormones in blood). All results were weighted on an average between the participants of each individual study group. The first group consisted of patients only on nebulized albuterol. The patients were administered 20mg of albuterol in 4ml of NS for a period of 10 minutes. At first changes in potassium levels seemed rather minute however 30mins after the treatments blood potassium levels dropped significantly. It is believed that this delay was caused because of how the medication is administered and how long it takes for the patients to start metabolizing the medication. After roughly 30 minutes a drop of roughly .4 millimols per liter (mmol/liter) was observed in patients on nebulized albuterol. After an hour a drop off roughly .6mmol/liter was observed. During the observation an increase of blood glucose of 2.5mmol/liter was observed in patients receiving only the nebulized albuterol. The next group was the group that received 10 units of insulin and 50ml of D50. In the insulin and D50 group, the patients were administered 10 units of insulin and 50ml of D50. The drop in blood potassium was significant in the first 15mins compared to the albuterol only group, having dropped roughly .5mmol/liter and reaching a reduction of roughly .6mmol/liter in only 45mins. However, as the observation time reached the 1 hour mark blood potassium levels had rebounded, showing a reduction of roughly .45mmol/liter when 15mins prior it had been a reduction of .6mmol/liter. As for the PBG the insulin and D50 group had a significant increase of pbg in the first 15mins rising 10mmol/liter from a base line of 4.5 and then settling down to roughly 3.5mmol/liter at the end of the 1 hour mark. The third
The article I chose for my grade insurance paper is “Albuterol and Insulin therapy in hemodialysis patients. http://www.nature.com/ki/journal/v38/n5/index.html. The reason I chose this article is because we have been going over potassium and action potential in class I have been extremely interested in potassium, part of this is because hyperkalemia is one of the few electrolyte imbalances we can start treatment for in a pre-hospital setting. The article was very informative and allowed me a new learning opportunity, it was fun to learn that some of the physiological process behind the treatment of hyperkalemia expanded into other physiological process such as glucose management and metabolic cycles. The hypothesis for this case study is that the combination of albuterol and insulin to control blood potassium is an additive effect. The control groups in this experiment were the patients given just albuterol, or just insulin, the variable was the patients given a combination of albuterol and insulin. Although this case study was done thoroughly and had several other studies supporting its findings, the case study its self was rather small only including 12 people with only 10 participants finishing the study. In the study the effects of albuterol, insulin with D50, and a combination of albuterol and insulin with 50ml of a 50% dextrose solution (D50) were administered to patients on hemodialysis. …show more content…
Patients were then monitored and tested for changes in Plasma blood glucose (pbg) and Potassium levels in the blood. The case study was small including only 12 patients broken up into 3 groups of 4, none of which were diabetics with ages ranging from 34-72, 2 of the patients in the study were removed. The patients were administered either 10 units of insulin and D50, or 20mg of albuterol in 4ml of normal saline (ns) over the course of 10 minutes, or patients were administered a combination of insulin and D50 as well as albuterol. The patients were then monitored for 1 hour with potassium and PBG being assessed every 15mins. All of the patients in the trial were not on beta blockers and had roughly the same lab values at the start of the trial, plasma blood glucose levels around 4.7 millimols per liter and blood potassium levels between 5.48-5.89 millimols per liter. The results of the case study were gathered by using heparinized tubes and a centrifuge immediately. Plasma potassium levels were analyzed using flame photometry (uses flame and flame color to measure concentration of alkali metals in a substance.), blood glucose was analyzed using a Beckman analyzer, and blood insulin levels were measured using radioimmunoassay (uses radioactive antigens to measure concentration of hormones in blood). All results were weighted on an average between the participants of each individual study group. The first group consisted of patients only on nebulized albuterol. The patients were administered 20mg of albuterol in 4ml of NS for a period of 10 minutes. At first changes in potassium levels seemed rather minute however 30mins after the treatments blood potassium levels dropped significantly. It is believed that this delay was caused because of how the medication is administered and how long it takes for the patients to start metabolizing the medication. After roughly 30 minutes a drop of roughly .4 millimols per liter (mmol/liter) was observed in patients on nebulized albuterol. After an hour a drop off roughly .6mmol/liter was observed. During the observation an increase of blood glucose of 2.5mmol/liter was observed in patients receiving only the nebulized albuterol. The next group was the group that received 10 units of insulin and 50ml of D50. In the insulin and D50 group, the patients were administered 10 units of insulin and 50ml of D50. The drop in blood potassium was significant in the first 15mins compared to the albuterol only group, having dropped roughly .5mmol/liter and reaching a reduction of roughly .6mmol/liter in only 45mins. However, as the observation time reached the 1 hour mark blood potassium levels had rebounded, showing a reduction of roughly .45mmol/liter when 15mins prior it had been a reduction of .6mmol/liter. As for the PBG the insulin and D50 group had a significant increase of pbg in the first 15mins rising 10mmol/liter from a base line of 4.5 and then settling down to roughly 3.5mmol/liter at the end of the 1 hour mark. The third