Relationship between acute hypercarbia and hyperkalaemia during surgery  

作　　者：Laurence Weinberg Amelia Russell Lois Mackley Charles Dunnachie Joshua Meyerov Chong Tan Michael Li Raymond Hu Dharshi Karalapillai 

机构地区：[1]Department of Anaesthesia,Austin Health,Melbourne,Victoria 3084,Australia [2]Department of Intensive Care,Austin Health,Melbourne,Victoria 3084,Australia [3]Melbourne Medical School,University of Melbourne,Victoria 3010,Australia

出　　处：《World Journal of Clinical Cases》2019年第22期3711-3717,共7页世界临床病例杂志

基　　金：Supported by An internal Research Grant from the Department of Anaesthesia

摘　　要：BACKGROUND The relationship between hyperkalaemia and metabolic acidosis is well described in the critical care setting;however,the relationship between acute respiratory acidosis and plasma potassium concentration is less well understood.In a controlled model of increasing levels of hypercarbia,we tested the hypothesis of whether increasing levels of hypercarbia are associated with changes in plasma potassium concentrations.AIM To determine whether increasing levels of hypercarbia are associated with changes in plasma potassium concentrations.METHODS We performed a post-hoc study examining changes in serum potassium in 24 patients who received increased levels of hypercarbia during cardiac surgery.Arterial blood gases and plasma concentrations of potassium were measured at baseline,3 min prior to,and then every 3 min for 15 min during the intervention of hypercarbia.The primary endpoint was the absolute change in serum K+at 15 min compared to the baseline K+value.The following secondary endpoints were evaluated:(1)The association between CO2 and serum K+concentration;and(2)The correlation between plasma pH and serum K+concentrations.RESULTS During the intervention,PaCO2 increased from 43.6 mmHg(95%CI:40.1 to 47.1)at pre-intervention to 83.9 mmHg(95%CI:78.0 to 89.8)at 15 min after intervention;P<0.0001.The mean(SD)serum potassium increased from 4.16(0.35)mmol/L at baseline to 4.28(0.33)mmol/L at 15 min(effect size 0.09 mol/L;P=0.22).There was no significant correlation between PaCO2 and potassium(Pearson’s coefficient 0.06;95%CI:-0.09 to 0.21)or between pH and potassium(Pearson’s coefficient-0.07;95%CI:-0.22 to 0.09).CONCLUSION Acute hypercarbia and subsequent respiratory acidaemia were not associated with hyperkalaemia in patients undergoing major surgery.BACKGROUND The relationship between hyperkalaemia and metabolic acidosis is well described in the critical care setting; however, the relationship between acute respiratory acidosis and plasma potassium concentration is less well understood. In a controlled model of increasing levels of hypercarbia, we tested the hypothesis of whether increasing levels of hypercarbia are associated with changes in plasma potassium concentrations.AIM To determine whether increasing levels of hypercarbia are associated with changes in plasma potassium concentrations.METHODS We performed a post-hoc study examining changes in serum potassium in 24 patients who received increased levels of hypercarbia during cardiac surgery.Arterial blood gases and plasma concentrations of potassium were measured at baseline, 3 min prior to, and then every 3 min for 15 min during the intervention of hypercarbia. The primary endpoint was the absolute change in serum K+ at 15 min compared to the baseline K+ value. The following secondary endpoints were evaluated:(1) The association between CO2 and serum K+ concentration; and(2)The correlation between plasma p H and serum K+ concentrations.RESULTS During the intervention, Pa CO2 increased from 43.6 mm Hg(95%CI: 40.1 to 47.1)at pre-intervention to 83.9 mm Hg(95%CI: 78.0 to 89.8) at 15 min after intervention; P < 0.0001. The mean(SD) serum potassium increased from 4.16(0.35) mmol/L at baseline to 4.28(0.33) mmol/L at 15 min(effect size 0.09 mol/L;P = 0.22). There was no significant correlation between Pa CO2 and potassium(Pearson’s coefficient 0.06; 95%CI:-0.09 to 0.21) or between p H and potassium(Pearson’s coefficient-0.07; 95%CI:-0.22 to 0.09).CONCLUSION Acute hypercarbia and subsequent respiratory acidaemia were not associated with hyperkalaemia in patients undergoing major surgery.

关 键 词：ANAESTHESIA INTENSIVE care BIOCHEMISTRY SURGERY 

分 类 号：R73[医药卫生—肿瘤]