Prevalence of hypokalemia before and after bowel preparation for colonoscopy in high-risk patients

Reumkens, Ankie; Masclee, Ad; Winkens, Björn; Deursen, C.T. van; Sanduleanu, Silvia; Bakker, C. M.

doi:10.1016/j.gie.2017.01.040

Cited by 19 publications

(23 citation statements)

References 22 publications

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“…Although bowel preparations based on polyethylene glycol minimize the loss of potassium, the incidence of hypokalemia increases five-to nine-fold after bowel preparation even for patients without underlying diseases. [7] In our previous study, the hypokalemia incidence was as high as 70%. [8] The clinical symptoms depend on the severity of hypokalemia.…”

Section: Discussionmentioning

confidence: 89%

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Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

Tan

Deng

et al. 2020

Preprint

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Background:In our previous study, hypokalemia incidence was high in patients scheduled for laparoscopic colorectal resection. The present trial was conducted to verify the effects of preoperative carbohydrate drinks containing potassium in these patients. Methods: Patients were randomly assigned to control, placebo, and case groups. In control group, patients were fasted from midnight. In placebo group, patients were fasted from midnight and received carbohydrate drinks 2–3 h before surgery. In case group, patients were fasted from midnight and received carbohydrate drinks containing potassium supplementation 2–3 h before surgery. The primary outcome was the incidence and severity of preoperative hypokalemia. The other outcomes included postoperative gastrointestinal function, including the time to postoperative first flatus (FFL) and first feces (FFE) and other complications. Results: The final analysis included 122 participants. The incidence of preoperative hypokalemia in case group was significantly lower than that in control and placebo groups (50% vs. 88.1% vs. 77.5%, p < 0.001). The severity of hypokalemia in control and placebo groups was greater than that in case group. No regurgitation or aspiration occurred in the three groups. No significant differences were observed among the three groups regarding time to FFL and FFE. Conclusions: Preoperative carbohydrate drinks containing potassium may have significantly reduced the incidence of preoperative hypokalemia and improved preoperative thirst and hunger, but did not improve postoperative well-being. However, as part of the enhanced recovery after surgery protocol, preoperative carbohydrate drinks containing potassium should be recommended, as early as first admittance to hospital.

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Section: Discussionmentioning

confidence: 89%

“…Bowel preparation is recommended for rectal surgery and remains controversial in colonic surgery. [1,7] Hypokalemia is associated with various symptoms, including gastrointestinal disorders, arrhythmia, and muscle weakness. Therefore, the importance of normal perioperative potassium levels might be underestimated.…”

Section: Introductionmentioning

confidence: 99%

Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

Tan

Deng

et al. 2020

Preprint

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“…It is generally accepted that the use of low‐volume bowel preparation method can accomplish modest efficacy and safety with greater willingness to repeat . However, these low‐volume methods still have some concerns about the complications caused by circulatory volume depletion, because low volume methods depend on the transluminal fluid shift to intraluminal space by ingestion of high osmolar preparation agents, it have risk of volume depletion. This mechanism could cause volume depletion resulting in acute kidney injury.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, 2 L PEG with ascorbic acid has been associated with acute kidney injury. There, further reduction in preparation volume is ideal to potentially further reduce this risk …”

Section: Introductionmentioning

confidence: 99%

“…There, further reduction in preparation volume is ideal to potentially further reduce this risk. 8,10 A low residue or clear liquid diet has been regarded to be optimal for successful preparation before colonoscopy, 2,[11][12][13] with only low to moderate evidence. 1,2 Reasons for this weak recommendation might arise from the difficulty in the intervention regarding diet control.…”

Section: Introductionmentioning

confidence: 99%

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Favorable outcomes of prepackaged low‐residue diet on bowel preparation for colonoscopy: Endoscopist‐blinded randomized controlled trial

Lee

Choi

Yoon

et al. 2018

J of Gastro and Hepatol

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Background and Aim 2 L polyethylene glycol plus an ascorbic acid (PEGA) is known to be as effective. However, 2 L polyethylene glycol‐based regimens are often still difficult for patients to tolerate. Therefore, we conducted this study to evaluate the potential of 1 L PEGA with prepackaged low‐residue diet (PLD) as an alternative to 2 L PEGA before colonoscopy. Methods The subjects were randomly assigned to either of the two groups. The 2 L PEGA group received 2 L PEGA split regimen. The 1 L PEGA with PLD group received PLD on the day preceding colonoscopy and 1 L PEGA. All endoscopic procedures were performed by one physician who did not know patients allocation. Bowel preparation status were graded using Boston Bowel Preparation Score (BBPS). A questionnaire regarding tolerability and safety was administered. This trial is registered at ClinicalTrials.gov (NCT03329339). Results A total of 173 patients completed the study (86 in the 2 L PEGA group and 87 in the 1 L PEGA with PLD group). Bowel preparation was adequate in 88.4% (76/86) of patients in the 2 L PEGA group and 93.1% of patients in the 1 L PEGA with PLD group (81/87, P = 0.28). The patients in the 1 L PEGA with PLD group had higher whole Boston Bowel Preparation Scale score (P = 0.02) and expressed more satisfaction and willingness to repeat the procedure (P < 0.01). There was no significant difference with respect to compliance or safety. Conclusion 1 L PEGA with PLD showed equivalent efficacy, greater satisfaction, and more willingness to repeat compared with 2 L PEGA for bowel preparation.

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Gynecologic/Oncology Surgery

Nelson

Bakkum-Gamez

Altman

et al. 2020

Enhanced Recovery After Surgery

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Prevalence of hypokalemia before and after bowel preparation for colonoscopy in high-risk patients

Cited by 19 publications

References 22 publications

Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

Favorable outcomes of prepackaged low‐residue diet on bowel preparation for colonoscopy: Endoscopist‐blinded randomized controlled trial

Gynecologic/Oncology Surgery

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