Author Affiliations: Intensive Care Unit, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland (Drs Perren and Previsdomini) (email@example.com); and Intensive Care Unit, Geneva University Hospitals, Geneva, Switzerland (Dr Bendjelid).
To the Editor: Dr Goyal and colleagues1 concluded that potassium levels greater than 4.5 mEq/L should probably be avoided because of an association with increased mortality. As a consequence, they challenge current clinical practice guidelines that endorse maintaining serum potassium levels between 4.0 and 5.0 mEq/L. There may be an association between potassium levels and mortality, but any conclusion that modifying the potassium level toward the range of 3.5 to 4.5 mEq/L will decrease mortality is still unproven. A pathological potassium level may simply reflect illness severity. Some issues remain to be addressed.
Perren A, Previsdomini M, Bendjelid K. Potassium Levels After Acute Myocardial Infarction. JAMA. 2012;307(15):1578-1580. doi:10.1001/jama.2012.485