Abstract
Management of hyperkalemia in patients receiving enteral tube feeding is often challenging, particularly in the presence of chronic organ dysfunction. We present a case report describing successful reduction of serum potassium concentration with a tube feeding regimen involving nocturnal infusion of a mixture of Deliver 2.0 (Mead Johnson Nutritionals, Evansville, IN) and sodium polystyrene sulfonate (SPS) powder. The patient described in this report has maintained acceptable serum potassium concentrations without significant alteration of other serum electrolyte parameters. Subsequent in vitro evaluation of Nutren 1.0/SPS (Clintec Nutrition Co, Deerfield, IL) and Deliver 2.0/SPS admixtures revealed that SPS in a concentration of 15 g/L produces a nearly 50% reduction in the potassium content of these enteral feeding formulations. A 30-g/L SPS concentration reduces potassium content by almost two thirds. This decrease in potassium content is accompanied by a reduction in magnesium content and an increase in sodium content.
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