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Objectives: Phlebitis caused by peripherally infused potassium chloride (KCl) is well documented in the literature. This study focuses on documenting the rate, grade, and timing of this complication, and explores the cause and effect of added lidocaine on pain and phlebitis rate. Methods: A retrospective chart review was conducted for patients receiving KCl peripheral infusion with or without added lidocaine. Descriptive statistical analysis was performed. The prevalence of infusion phlebitis was evaluated using the appropriate X2 test, t-test/Mann-Whitney U test. A multivariate Cox proportional hazards regression model was used to assess the independent effect of age and sex on the rate of catheter-related complications. Statistical significance was considered at P < 0.05. Results: There were 85 infusions of 10 and 20 mEq KCl, of which 67% (N = 57) had added lidocaine. Overall, phlebitis rate was 19%. There was less phlebitis with lidocaine-added infusions (13% vs 19%; P = 0.65), and infusions lasted more than those without added lidocaine. Animal and human data support the occurrence of a KCl-mediated vasoconstriction causing pain. Our data anecdotally support such observations. Besides the low pH and high osmolarity of KCl infusions, vasoconstriction seems to add insult to the patient veins. The role of lidocaine in alleviating pain and in delaying phlebitis may go beyond being a local anesthetic once its vasodilatory and anti-inflammatory effects are considered. Conclusions: The cause of pain and phlebitis of KCl infusions may be more related to vasoconstriction than just low pH and high osmolarity. The addition of lidocaine to KCl infusions appears to be safe, and potentially delays or alleviates KCl infusion pain through its speculative vasodilatory and anti-inflammatory effects. [ABSTRACT FROM AUTHOR]

Objectives: Chronic heart failure (CHF) is a global health issue with notable morbidity and mortality. Currently, red cell distribution width (RDW) has appeared to be potential prognostic marker in patients with CHF.This study aims to assess the prognostic value of RDW in Saudi population with CHF. Methods: This study was a retrospective cohort study that included 233 CHF patients treated with standard antifailure drugs. RDW were ascertained at baseline with 2-D echocardiographic assessments of left ventricular mass and function. The follow up period was 24 months. Primary endpoint was the relationship between RDW and allcause mortality (ACM). Secondary endpoints included the potential association with major adverse cardiovascular events (classical 3-point MACE). Results: The mean age of patients was 60.15 ± 12.24 years, and 64.8% were males. Baseline RDW was 14.40 (13.50, 15.80) % (median, and interquartile ranges); 43 deaths occurred during the follow-up period. RDW was found to be the most significant and independent predictor of ACM, with a hazard ratio (HR) of 1.238 (95% CI; 1.090, 1.407) (P=0.001). While RDW change over 12 months had similar predictive value for ACM with HR 1.226 (95% CI; 1.117, 1.346) (P<0.0001). RDW was also found to be a significant and independent predictor for secondary endpoints. Conclusion: Our study supports the usefulness of RDW as an independent prognostic indicator for ACM and other CV outcomes in Saudi population with CHF. [ABSTRACT FROM AUTHOR]