Temporal Pattern and Prognostic Significance of Hypokalemia in Patients Undergoing Targeted Temperature Management Following Cardiac Arrest

Nayeri, Arash; Glück, H.; Farber‐Eger, Eric; Krishnan, Srikanth; Shamsa, Kamran; Lee, Michael; Wells, Quinn S.; McPherson, John

doi:10.1016/j.amjcard.2017.06.051

Cited by 9 publications

(12 citation statements)

References 12 publications

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“…ITH is known to be associated with hypokalemia but, as noted, the mechanism is not well understood [ 10–12 , 15 , 17 , 27 , 30 ]. Out of the 74 patients we were able to survey who had undergone ITH at our institution, 44 (59.5%) developed hypokalemia despite the administration of K + supplements during the cooling phase, which is consistent with other studies [ 9–11 ].…”

Section: Discussionmentioning

confidence: 99%

Serum potassium changes during hypothermia and rewarming: a case series and hypothesis on the mechanism

Boubes

Batlle

Tang

et al. 2022

Clinical Kidney Journal

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Introduction Hypokalemia is known to occur in association with therapeutically induced hypothermia and is usually managed by the administration of potassium (K+). Methods We reviewed data from 74 patients who underwent therapeutic hypothermia protocol at our medical institution. Results In 4 patients in whom close data on serum K+ and temperature was available, a strong positive correlation between serum K+ and body temperature was found during the rewarming phase when serum K+ increased. Based on the close positive relationship between serum K+ and total body temperature, we hypothesize that serum K+ falls during hypothermia owing to decreased activity of temperature dependent K+ exit channels that under normal conditions are sufficiently active to match cellular K+ intake via Na+/K+/ATPase. Upon rewarming, reactivation of these channels results in a rapid increase in serum K+ as a result of K+ exit down its concentration gradient. Conclusion Administration of K+ during hypothermia should be done cautiously and avoided during rewarming to avoid potentially life threatening hyperkalemia. K+ exit via temperature dependent K+ channels provides a logical explanation for the rebound hyperkalemia. K+ exit channels may play a bigger role than previously appreciated in the regulation of serum K+ during normal and pathophysiological conditions.

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Section: Discussionmentioning

confidence: 99%

Serum potassium changes during hypothermia and rewarming: a case series and hypothesis on the mechanism

Boubes

Batlle

Tang

et al. 2022

Clinical Kidney Journal

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“…Electrolytes should be monitored every 4–6 h and should be repleted appropriately. Potassium repletion should be held 4 h prior to rewarming because reversal of cellular shift may result in hyperkalemia [ 86 ].…”

Section: High-quality Ttmmentioning

confidence: 99%

Targeted Temperature Management in Cardiac Arrest: An Updated Narrative Review

Belur

Sedhai

Truesdell³

et al. 2022

Cardiol Ther

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The established benefits of cooling along with development of sophisticated methods to safely and precisely induce, maintain, monitor, and reverse hypothermia have led to the development of targeted temperature management (TTM). Early trials in human subjects showed that hypothermia conferred better neurological outcomes when compared to normothermia among survivors of cardiac arrest, leading to guidelines recommending targeted hypothermia in this patient population. Multiple studies have sought to explore and compare the benefit of hypothermia in various subgroups of patients, such as survivors of out-of-hospital cardiac arrest versus in-hospital cardiac arrest,

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“…Particularly, the negative effects of hypopotassaemia and hypomagnesemia were highlighted. Hypopotassaemia has been linked to cardiac arrhythmia 5‐7 8 .…”

Section: Introductionmentioning

confidence: 99%

Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest

Kirkegaard

Grejs

Gudbjerg

et al. 2022

Acta Anaesthesiol Scand

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Background: Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM.Methods: This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements.Results: On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p < .05) during the first 24 h. Magnesium concentration stayed within the reference interval. Median ionized calcium concentration increased from 1.11 (IQR 1.1-1.2) mmol/l during the first 24 h (p < .05), whereas

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Temporal Pattern and Prognostic Significance of Hypokalemia in Patients Undergoing Targeted Temperature Management Following Cardiac Arrest

Cited by 9 publications

References 12 publications

Serum potassium changes during hypothermia and rewarming: a case series and hypothesis on the mechanism

Serum potassium changes during hypothermia and rewarming: a case series and hypothesis on the mechanism

Targeted Temperature Management in Cardiac Arrest: An Updated Narrative Review

Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest

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