The heart and potassium: A banana republic

Khan, E.U.; Spiers, Christine; Khan, Maria Usman

doi:10.3109/17482941.2012.741250

Cited by 9 publications

(11 citation statements)

References 21 publications

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“…Hyperkalemia inhibits repolarization and may result in delayed AV conduction, AV block, extrasystoles and bradycardia [23] . These symptoms of hyperkalemia overlap with symptoms of lidocaine-associated cardiac events, making conclusions about a causal relation of lidocaine and cardiac events in the presence of hyperkalemia more difficult.…”

Section: Discussionmentioning

confidence: 99%

Lidocaine-Associated Cardiac Events in Newborns with Seizures: Incidence, Symptoms and Contributing Factors

Weeke

Schalkwijk²,

Toet³

et al. 2015

Neonatology

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Background: Lidocaine is an effective therapy for neonatal seizures; however, it is not widely used, presumably due to the risk of cardiac events. Objective: To investigate the incidence of cardiac events in full-term and preterm infants receiving lidocaine for seizures. Methods: Full-term (n = 368) and preterm (n = 153) infants, admitted to a level 3 neonatal intensive care unit from 1992 to 2012, who received lidocaine for seizures were retrospectively studied. The causal relation between reported cardiac events and lidocaine administration was evaluated based on expected plasma concentrations, symptoms and relevant interactions during cardiac events. Results: Cardiac events were reported in 11/521 infants (2.1%; 9 full-term, 2 preterm). In 7/11 infants the causal relation was considered plausible, in 3/11 questionable and in 1/11 implausible. The incidence was calculated to be 1.3-1.9% (n = 7-10/521), but was only 0.4% (n = 1/246, p = 0.02) when using reduced-dose regimens. Important risk factors for cardiac events were unstable potassium, (congenital) cardiac dysfunction and concurrent phenytoin use. Conclusions: Lidocaine-associated cardiac events were rare in our cohort, especially since the introduction of new reduced-dose regimens. This indicates that lidocaine is safe to use as an antiepileptic drug in full-term and preterm infants.

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Section: Discussionmentioning

confidence: 99%

Lidocaine-Associated Cardiac Events in Newborns with Seizures: Incidence, Symptoms and Contributing Factors

Weeke

Schalkwijk²,

Toet³

et al. 2015

Neonatology

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“…Ischemic arrhythmia is one of important pathogenesis lead to death in heart diseases [3]. Potassium channels are involved in cardiac repolarization [7], and classical inward-rectifier potassium channels (Kir), an important class of potassium ion channels, can regulate the excitability of cardiomyocytes and maintenance of resting potential of myocardial cells [8,9]. Normal heart rhythm depends on heart diastole and systole which is caused by the currents from the openness and closeness of ion channels on myocardial cell membrane [5].…”

Section: Introductionmentioning

confidence: 99%

The Beneficial Effects of Electro-acupuncture at PC6 (Neiguan-point) of Gene and Protein Expressions of Classical Inward-rectifier Potassium Channels in Myocardial Ischemic Rats

Wang¹,

Zhang²,

Wang³

et al. 2016

acupunct electrother res

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336 wANg, Y.; zHANg, X.; wANg, w.; LI, d.; dAI, J.; LI, C.; LI, J., CHEN, Y.; RONg, P.2 electrocardiograms (ECGs) after every injection. Electro-acupuncture (EA) was operated at PC6, LU7 and non-acupoint respectively in the rats of PC6 group, LU7 group and non-acupoint group after twice injections. EA was performed to these three groups with disperse-dense wave (4-20Hz), pulse amplitude of 14V, 20mins a day remaining 7 days. The gene and protein expressions of Kir2.1, Kir2.2 and Kir2.3 were analyzed by Western Immunoblotting Technology (Western Blot) and Real-time Fluorescence Quantitative Polymerase Chain Reaction (RT-PCR). But it is regrettable that we did not detect meaningful gene and protein expressions Kir2.3, and the expressions of Kir2.1 and Kir2.2 in MI induced groups were lower [The gene and protein decreased 39.4±27.3% and 38.7±17.1% respectively.] than control group (P<0.05). Compared with MI group, the results of PC6 group and LU7 group increased [PC6 group: the gene and protein increased 42.9± 25.0% and 42.2±10.0% respectively. LU7 group: the gene and protein increased 23.8±50.1% and 21.1±32.5% respectively.] obviously (P<0.05) after EA, furthermore the expressions of PC6 group were higher [The gene and protein increased 15.4±16.7% and 17.3±60% respectively.] than LU7 group (P<0.05). The results show that PC6 has a better positive effect than LU7 on MI rats, and the mechanism is probably that EA at PC6 can significantly increase the gene and protein expressions of Kir2.1 and Kir2.2.

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“…e potassium est un ion essentiel pour le fonctionnement cellulaire. Il détermine le voltage et l'excitabilité des myocytes et des neurones [1][2][3]. Environ 10 % du potassium est excrété dans les selles et la majorité du potassium absorbé l'est dans les urines [2].…”

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“…Le néphron régule la réabsorption potassique à plusieurs niveaux, avec un rôle prédominant de l'aldostérone au niveau du tubule collecteur ; la capacité d'excrétion potassique rénale diminue dès que le débit de filtration glomérulaire (DFG) est < 60 mL/min/1,73m 2 . Cependant, des mécanismes d'adaptation permettent d'augmenter la sécrétion urinaire de potassium, principalement par l'action de l'aldostérone [1][2][3]. La diminution du flux sanguin rénal est associée à un risque élevé d'hyperkaliémie [2].…”

unclassified

“…L'hyperkaliémie aiguë induit dans le myocyte une augmentation de la durée de repolarisation et un ralentissement de la conduction intraventriculaire provoquant des troubles du rythme pouvant être fatals. Les modifications typiques observées à l'ECG s'aggravent proportionnellement avec l'élévation de la kaliémie : -l'onde T devient pointue, symétrique ; -le QTc raccourcit ; -l'amplitude du QRS s'atténue ; -le QRS s'élargit pouvant entraîner des troubles conductifs ou des arythmies parfois létales (bloc auriculo-ventriculaire, bloc sino-auriculaire, échappement jonctionnel, extrasystoles, fibrillation atriale, troubles du rythme ventriculaire et asystolie) [1,3].…”

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Assessment of the population at risk of hyperkalemia

Berrut

Boureau

Decker

et al. 2020

Gériatrie Et Psychologie Neuropsychiatrie Du Viellissement

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Le potassium est un ion essentiel pour le fonctionnement cellulaire, il détermine le voltage et l'excitabilité des myocytes. Son homéostasie est dépendante de l'apport alimentaire et de son élimination rénale prédominante. Le système rénine angiotensinealdostérone (SRAA) en régule l'élimination. L'hyperkaliémie aiguë et chronique est un facteur de risque de mortalité d'origine cardiaque. L'insuffisance rénale chronique et l'insuffisance cardiaque sont les principales comorbidités. Les traitements inhibiteurs du SRAA sont les principaux facteurs iatrogéniques de l'hyperkaliémie. Environ 90 % des patients qui présentent une hyperkaliémie ont plus de 50 ans et 43 % ont plus de 75 ans. Seuls 4,9 % des hyperkaliémies ont une prise en charge thérapeutique par résines. Un tiers des patients ont 3 comorbidités, et 14 % ont 5 comorbidités ou plus. Les principales comorbidités sont une hypertension artérielle (74,0 %), une dyslipidémie (56,3 %), une insuffisance rénale (55,2 %), un diabète (44,7 %), une maladie coronarienne telle que l'angor et l'infarctus du myocarde (23,3 %) et une insuffisance cardiaque (12 %). Il est à noter que les deux tiers des patients recevant des résines, recevaient également des ISRAA et présentaient une tendance à avoir plus de comorbidités. L'hyperkaliémie est sous-estimée et nécessite une surveillance stricte chez les patients présentant une insuffisance rénale ou une insuffisance cardiaque. Les résines ne sont pas adaptées à une bonne observance au long cours et de nouveaux traitements tels que le patiromer, permettraient de réduire le risque d'hyperkaliémie.

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The heart and potassium: A banana republic

Cited by 9 publications

References 21 publications

Lidocaine-Associated Cardiac Events in Newborns with Seizures: Incidence, Symptoms and Contributing Factors

Lidocaine-Associated Cardiac Events in Newborns with Seizures: Incidence, Symptoms and Contributing Factors

The Beneficial Effects of Electro-acupuncture at PC6 (Neiguan-point) of Gene and Protein Expressions of Classical Inward-rectifier Potassium Channels in Myocardial Ischemic Rats

Assessment of the population at risk of hyperkalemia

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