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Review
. 2025 May 28;17(5):e84978.
doi: 10.7759/cureus.84978. eCollection 2025 May.

Potassium Replacement Practices and Their Association With Blood Transfusion Outcomes in Surgical and Critical Care Patients: A Systematic Review

Muhammad Yousuf  1 , Jarallah H J Alkhazendar  2 , Aliaa H Alkhazendar  3 , Syed Muhammad Baqar Raza  4   5 , Maria Javed  6   7 , Soban Haider  8 , Shahzad Ahmad  9
Affiliations
Review

Potassium Replacement Practices and Their Association With Blood Transfusion Outcomes in Surgical and Critical Care Patients: A Systematic Review

Muhammad Yousuf et al. Cureus. .

Abstract

This systematic review examines the association between potassium replacement strategies and blood transfusion outcomes in surgical and critical care settings. Despite the frequent use of potassium supplementation to address hypokalemia in hospitalized patients, its direct and indirect impact on transfusion requirements remains underrecognized. A structured literature search identified five eligible studies that investigated both potassium management and transfusion outcomes across diverse high-acuity populations. Findings revealed that aggressive or routine electrolyte monitoring and replacement may contribute to iatrogenic anemia through repeated phlebotomy, while preoperative hypokalemia was associated with increased need for transfusion in select cohorts. Although the degree of association varied, several studies suggested that individualized potassium replacement protocols could play a role in optimizing transfusion practices. These insights highlight the importance of integrated electrolyte and transfusion management to improve patient safety and conserve resources in perioperative and intensive care environments.

Keywords: blood transfusion; critical care; electrolyte imbalance; hemoglobin; hypokalemia; icu; perioperative management; potassium replacement; surgery; transfusion outcomes.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. The PRISMA flowchart represents the study selection process.
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
See this image and copyright information in PMC

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