THE EFFECT IN HUMANS OF EXTRACELLULAR pH CHANGE ON THE RELATIONSHIP BETWEEN SERUM POTASSIUM CONCENTRATION AND INTRACELLULAR POTASSIUM 1

Burnell, James M.; Villamil, M. F.; Uyeno, Ben T.; Scribner, Belding H.

doi:10.1172/jci103352

Cited by 257 publications

(42 citation statements)

References 6 publications

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“…Classic papers also stated2, 21 that metabolic acidosis causes an increase of plasma K + independently of intracellular potassium stores. This is supported by our finding that a decline of plasma K + during the first 24 hours of treatment occurred even in calves that were presented with normokalemia and that a hypokalemic state with plasma K + < 3.9 mmol/L was evident in 19.3% of calves at T 24h.…”

Section: Discussionmentioning

confidence: 99%

“…Classic papers stated that a 0.1 unit reduction in venous blood pH results in an increase of plasma K + of 0.3–0.5 mmol/L23 or 0.6 mmol/L 21. However, it was recently reported8 that this linear interrelation does not reflect the situation in diarrheic calves and that the presence of hyperkalemia depended on the nature of an existing acidosis but more importantly on the degree of dehydration.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for the Development of Hypokalemia in Neonatal Diarrheic Calves

Trefz

Lorch

Zitzl

et al. 2015

Veterinary Internal Medicne

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BackgroundNeonatal diarrheic calves have a clear negative potassium balance because of intestinal losses and decreased milk intake but in the presence of acidemia, they usually show normokalemic or hyperkalemic plasma concentrations.ObjectivesTo assess whether marked hypokalemia occurs in response to the correction of acidemia and dehydration and to identify factors that are associated with this condition.AnimalsEighty‐three calves with a clinical diagnosis of neonatal diarrhea.MethodsProspective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate, 0.9% saline and 40% dextrose infusion solutions.ResultsThe proportion of hypokalemic calves after 24 hours of treatment (19.3%) was twice as great as it was on admission to the hospital. Plasma K+ after 24 hours of treatment was not significantly correlated to venous blood pH values at the same time but positively correlated to venous blood pH values on admission (r = 0.51, P < .001). Base excess on admission (Odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.70–0.94), duration of diarrhea (OR = 1.37, 95% CI = 1.05–1.80), milk intake during hospitalization (OR = 0.54, 95% CI = 0.37–0.79) and plasma sodium concentrations after 24 hours (OR = 1.12, 95% CI = 1.01–1.25) were identified to be independently associated (P < .05) with a hypokalemic state after 24 hours of treatment.Conclusions and Clinical ImportanceFindings of this study suggest that marked depletion of body potassium stores is evident in diarrheic calves that suffered from marked metabolic acidosis, have a low milk intake and a long history of diarrhea.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors for the Development of Hypokalemia in Neonatal Diarrheic Calves

Trefz

Lorch

Zitzl

et al. 2015

Veterinary Internal Medicne

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show abstract

“…Even when potassium supplements are given the serum potassium may continue to fall (Abramson and Arky, 1966). The rising blood pH itself causes a decrease of the serum potassium (Burnell et al, 1956) and administration of sodium bicarbonate naturally accelerates this. The amount of intravenous sodium bicarbonate given to patients in whom severe metabolic acidosis exists should therefore be limited; some workers oppose its routine use altogether (Root and Nichols, 1959;Young and Bradley, 1967).…”

Section: Discussionmentioning

confidence: 99%

Diabetic Ketoacidosis During the Influenza Epidemic

Watkins¹,

Soler²,

Fitzgerald³

et al. 1970

BMJ

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“…18 Acidosis is accepted as causing a loss of intracellular potassium,"9 and it is' known that alkalosis raises the intracellular potassium at the expense of extracellular levels. 20 The muscle end-plate potential is closely linked to the ratio of extracellular to intracellularpotassium.21 Rapid alterations of this ratio could lead either to hyperpolarization or to partial depolarization of the endplate, thus interfering with the muscle's response to nerve impulses.22"4 Such a swing between the two extremes may have been achieved by Dr. Bourne and Dr. Shackleton by rapid transition from respiratory acidosis to respiratory alkalosis (Journal, December 22, 1956December 22, , p. 1485. Perhaps this is the connexion between persistent curarization and respiratory acidosis that several of your correspondents recently have remarked.…”

Section: Bolus Obstructionmentioning

confidence: 99%

Neostigmine-resistant Curarization

Foster¹

1957

BMJ

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THE EFFECT IN HUMANS OF EXTRACELLULAR pH CHANGE ON THE RELATIONSHIP BETWEEN SERUM POTASSIUM CONCENTRATION AND INTRACELLULAR POTASSIUM 1

Cited by 257 publications

References 6 publications

Risk Factors for the Development of Hypokalemia in Neonatal Diarrheic Calves

Risk Factors for the Development of Hypokalemia in Neonatal Diarrheic Calves

Diabetic Ketoacidosis During the Influenza Epidemic

Neostigmine-resistant Curarization

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