Hypercapnia and Hyperkalaemia

Hassan, Hafeez; Gjessing, J; Tomlin, P. J.

doi:10.1097/00132586-198012000-00045

Cited by 5 publications

(6 citation statements)

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“…A linear relationship between PaCO 2 and [K + ] p was observed and the authors reported that [K + ] p increased by 0.30 mmol/L after 90 min of induced hypercarbia. Our findings are also aligned with others [25] showing that PaCO 2 and [K + ] p are related, even with minor degrees of hypercarbia. Hassan et al [25], reported that [K + ] p increased by 0.39 mmol/L per every 7.5 mmHg increase in PaCO 2 , a greater increase compared to the present study.…”

Section: Discussionsupporting

confidence: 92%

“…Our findings are also aligned with others [25] showing that PaCO 2 and [K + ] p are related, even with minor degrees of hypercarbia. Hassan et al [25], reported that [K + ] p increased by 0.39 mmol/L per every 7.5 mmHg increase in PaCO 2 , a greater increase compared to the present study. Hassan's findings were almost identical to that reported by Edwards et al [26], who showed that [K + ] p increased by 0.4 mmol/Lper 10 mmHg change in PaCO 2 , a doubling of what was observed in the present study.…”

Section: Discussionsupporting

confidence: 92%

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The association of acute hypercarbia and plasma potassium concentration during laparoscopic surgery: a retrospective observational study

et al. 2021

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Background It is uncertain whether increases in PaCO2 during surgery lead to an increase in plasma potassium concentration and, if so, by how much. Hyperkalaemia may result in cardiac arrhythmias, muscle weakness or paralysis. The key objectives were to determine whether increases in PaCO2 during laparoscopic surgery induce increases in plasma potassium concentrations and, if so, to determine the magnitude of such changes. Methods A retrospective observational study of adult patients undergoing laparoscopic abdominal surgery was perfomed. The independent association between increases in PaCO2 and changes in plasma potassium concentration was assessed by performing arterial blood gases within 15 min of induction of anaesthesia and within 15 min of completion of surgery. Results 289 patients were studied (mean age of 63.2 years; 176 [60.9%] male, and mean body mass index of 29.3 kg/m2). At the completion of the surgery, PaCO2 had increased by 5.18 mmHg (95% CI 4.27 mmHg to 6.09 mmHg) compared to baseline values (P < 0.001) with an associated increase in potassium concentration of 0.25 mmol/L (95% CI 0.20 mmol/L to 0.31 mmol/L, P < 0.001). On multiple regression analysis, PaCO2 changes significantly predicted immediate changes in plasma potassium concentration and could account for 33.1% of the variance (r2 = 0.331, f(3,259) = 38.915, P < 0.001). For each 10 mmHg increment of PaCO2 the plasma potassium concentration increased by 0.18 mmol/L. Conclusion In patients receiving laparoscopic abdominal surgery, there is an increase in PaCO2 at the end of surgery, which is independently associated with an increase in plasma potassium concentration. However, this effect is small and is mostly influenced by intravenous fluid therapy (Plasma-Lyte 148 solution) and the presence of diabetes. Trial registration Retrospectively registered in the Australian New Zealand Clinical Trials Registry (Trial Number: ACTRN12619000716167).

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

The association of acute hypercarbia and plasma potassium concentration during laparoscopic surgery: a retrospective observational study

et al. 2021

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“…This promotes efflux of potassium ions from the cells in exchange for hydrogen ions, potentially leading to hyperkalaemia. In humans, it is reported that for every 7.5 mmHg increase in the arterial partial pressure of carbon dioxide (PaCO 2 ) there is an increase of 0.39 mmol/l of plasma potassium concentration 26. However, there are conflicting reports in the literature regarding the association between acute respiratory acidosis and the development of hyperkalaemia in humans27–29 and in dogs,30 31 and there does not appear to exist a general consensus as to whether increased PaCO 2 leads to significant increases in potassium or not.…”

Section: Discussionmentioning

confidence: 99%

Life‐threatening hyperkalaemia during general anaesthesia in a domestic short‐haired cat

Felisberto

Auckburally

Flaherty

2020

Vet Record Case Reports

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There are an increasing number of reports describing the development of hyperkalaemia in healthy veterinary patients during general anaesthesia. While the majority of cases are dogs, it has also been described in large non-domestic cats under general anaesthesia. To the authors’ knowledge, there are no reported cases of acute hyperkalaemia in healthy domestic cats associated with anaesthesia. This case report describes the development of hyperkalaemia in a nine-year-old domestic short-haired cat, anaesthetised for fracture repair. Hyperkalaemia (8.0 mmol/l) was recognised due to the sudden development of bradycardia, spiked T waves, decreased amplitude of P waves, progressing to atrial standstill on the ECG. Initial treatment was with calcium gluconate, insulin and glucose, which resolved the problem, but the hyperkalaemia recurred during recovery from anaesthesia, necessitating further treatment. Possible causes of the hyperkalaemia are discussed.

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“…The level of hyperkalaemia seen in this case was beyond that likely to be caused by respiratory depression alone. Serum potassium levels have been found to increase by 0.3–0.4 mmol/l for every 7.5 mmHg increase in arterial carbon dioxide partial pressure 7. This would equate to an increase of 0.7–1.0 mmol/l in serum potassium concentration compared with the 3.87 mmol/l increase seen, and therefore alternative explanations are sought.…”

Section: Discussionmentioning

confidence: 99%

Repeated hyperkalaemia during two separate episodes of general anaesthesia in a nine-year-old, female neutered greyhound

McFadzean¹,

MacFarlane²,

Khenissi³

et al. 2018

Vet Rec Case Rep

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There is an increasing awareness of the development of hyperkalaemia during anaesthesia in otherwise healthy veterinary patients. In the human literature 63 per cent of in-hospital hyperkalaemic episodes are associated with drug administration. Anecdotal veterinary reports have suggested that a genetic component may also play a role, with greyhounds seemingly more susceptible to the development of hyperkalaemia under anaesthesia. This case report identifies the repeated development of hyperkalaemia, and its treatment, during two separate episodes of general anaesthesia in a nine-year-old, female neutered greyhound. The first episode of hyperkalaemia (7.89 mmol/l) was identified due to bradycardia and second-degree atrioventricular block on electrocardiogram. Treatment was with intravenous calcium gluconate, insulin, glucose and fluid therapy. The second episode (6.60 mmol/l) was associated with spiked T-waves, and treatment was with insulin and glucose infusions to allow completion of the anaesthetic and surgery. Possible causes and treatments are discussed, and the need for reporting of such cases is highlighted.

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Hypercapnia and Hyperkalaemia

Cited by 5 publications

References 0 publications

The association of acute hypercarbia and plasma potassium concentration during laparoscopic surgery: a retrospective observational study

The association of acute hypercarbia and plasma potassium concentration during laparoscopic surgery: a retrospective observational study

Life‐threatening hyperkalaemia during general anaesthesia in a domestic short‐haired cat

Repeated hyperkalaemia during two separate episodes of general anaesthesia in a nine-year-old, female neutered greyhound

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