HELP ! Potassium Acetate as a work-around for KCL Shortage ?

Editors Note:

Have any of you out there ever used or considered using Potassium Acetate as a work around for KCL Shortage?

I personally have zero experience with it- but the thought had crossed my mind in light of the current situation. 

I saw this post from Jim Patterson, CCP on Perflist and asked him for permission to pose the question to a broader international audience here on Circuit Surfers.

ALL opinions or suggestions are more than welcome 🙂

My original post to Perflist re: Potassium Acetate substitution for KCl netted no response.  

“In discussing this with our surgeons, they did not want to be the ones that blazed the trail as our caseload is down because of a number of issues (the denominator now plays a much greater role).

We use the Master/Follower Technology on Terumo’s System One.  Currently our CDPG consists of:  

50ml KCl (100meq),
5ml MgSO4 (2.5g)
and 145 ml 0.45% NaCl for a total of 200ml.  

We consistently use less than 75ml of the 200ml bag, so we are looking to split our bags into 3 (maybe 4) to try to conserve what KCl we have.

I know this may not be the solution for the number of people that contacted me, but I have nothing else currently.  We use Plasmlyte to prime our circuit and it has 27 meq/L of Acetate.  I’m not sure how that amount was determined but our blood CDPG could expose the myocardium upwards of 4 fold or better upon dosing.

Again, I’m not sure what that means, but, at this point, we will be looking for other alternatives.”

jim

A Work Around for Quest MPS Users

  • A Thermal Coil
  • Coil / Bucket Holder
  • Manometer
  • Manometer Holder

Click to view manufacturer product page

Click to view manufacturer product page

Editors Note:

This is NOT an advertisement for the above products. 

But when discussing it with a good friend and colleague of mine, and in light of the fact that we use the Quest MPS as our cardioplegia delivery system, this seemed to be a reasonable solution. 

My experience with this system ranges 4 years- and it is a solid performer, and effective cooling system.

It allows us to adjust well to the KCL shortage- and eliminates the need for additional heater/cooler hardware additions or heater / cooler modifications.

Any suggestions are welcome ?