Effects of Potassium Supplementation in Patients With Left Ventricular Dysfunction After Coronary Artery Bypass Grafting / 中国循环杂志

ABSTRACT

Objectives: To investigate the effects of potassium supplementation after coronary artery bypass grafting (CABG) in patients with reduced left ventricular ejection fraction (EF < 50%). Methods: Present study retrospectively analyzed data from 200 CABG patients with cardiopulmonary bypass from January 2015 to June 2017. Patients were divided as heart failure with high ideal potassium supplement group (low EF<50%, potassium supplement to 5.0 mmol/L, n=41); heart failure normal potassium supplement group (low EF<50%, potassium supplement to 4.5 mmol/L, n=46); and normal potassium supplement group (normal EF>50%, potassium supplement to 4.5 mmol/L, n=113). The differences on related parameters during intraoperative and postoperative period were compared among the 3 groups. The primary endpoint was the incidence of atrial and ventricular arrhythmias requiring the use of lidocaine and amiodarone hydrochloride. Results:Atrial and ventricular arrhythmias requiring lidocaine and amiodarone hydrochloride were found in 13 patients (31.7%) in the ideal hyperkalemia group, while 28 (62.2%) in the normal hyperkalemia group needed both drugs (P=0.005). The blood pressure of ideal high potassium supplementation group was significantly higher than that of normal potassium supplementation group ([135.87±11.32] mmHg vs [111.21±31.31] mmHg, P<0.001). In the ideal hyperkalemia group, the time in the ICU was shorter ([3.92±0.98]days vs [5.12±1.12]days, P<0.001) and the hospitalization time was shorter ([10.54±2.14] days vs [13.54±2.01]days, P<0.001). There was no significant difference between the two groups in postoperative 24-hour urine volume, oxygen partial pressure, postoperative 24-hour bleeding volume and postoperative complications (P>0.05). Conclusions:The ideal potassium target of 5.0 mmol/L for patients with LVEF<50% CABG can reduce the incidence of arrhythmias that require the intervention of lidocaine and amiodarone hydrochloride during the perioperative period and shorten the stay time in the ICU.