Replacement is required. (A)

Replacement therapy should be based on serum potassium measurements. (E)

Start potassium replacement immediately if the patient is hypokalaemic; otherwise, start potassium concurrent with starting insulin therapy. If the patient is hyperkalaemic, defer potassium until urine output is documented. (E)

Starting potassium concentration in the infusate should be 40 mmol/l (E) and potassium replacement should continue throughout intravenous fluid therapy. (E)

There is no evidence that replacement has clinical benefit (A). Severe hypophosphataemia should be treated. (C)

Potassium phosphate salts may be used as an alternative to or combined with potassium chloride/acetate. (C)

Administration of phosphate may induce hypocalcaemia. (C)

Other acute resuscitation protocols no longer recommend bicarbonate administration unless the acidosis is “profound” and “likely to affect the action of adrenaline/epinephrine during resuscitation”. (A)

Fluid and insulin replacement without bicarbonate administration corrects ketoacidosis. (A)

Data show that treatment with bicarbonate confers no clinical benefit. (B)

Repair fluids containing various buffering agents (bicarbonate, acetate, lactate) have been used (C). The efficacy and safety of these agents have not been established.