Hyperkalemia accompanies hemorrhagic shock and correlates with mortality
Clinics
;
64(6): 591-597, June 2009. graf
Article
Dans Anglais
| LILACS
| ID: lil-517930
ABSTRACT
OBJECTIVE:
This study was designed to evaluate the effects of terlipressin versus fluid resuscitation with normal saline, hypertonic saline or hypertonic-hyperoncotic hydroxyethyl starch, on hemodynamics, metabolics, blood loss and short-term survival in hemorrhagic shock.METHOD:
Twenty-nine pigs were subjected to severe liver injury and treated 30 min later with either (1) 2 mg terlipressin in a bolus, (2) placebo-treated controls, (3) 4 mL/kg 7.5% hypertonic NaCl, (4) 4 mL/kg 7.2% hypertonic-hyperoncotic hydroxyethyl starch 200/0.5, or (5) normal saline at three times lost blood volume.RESULTS:
The overall mortality rate was 69%. Blood loss was significantly higher in the hypertonic-hyperoncotic hydroxyethyl starch and normal saline groups than in the terlipressin, hypertonic NaCl and placebo-treated controls groups (p<0.005). Hyperkalemia (K>5 mmol/L) before any treatment occurred in 66% of the patients (80% among non-survivors vs. 22% among survivors, p=0.019). Post-resuscitation hyperkalemia occurred in 86.66% of non-survivors vs. 0% of survivors (p<0.001). Hyperkalemia was the first sign of an unsuccessful outcome for the usual resuscitative procedure and was not related to arterial acidemia. Successfully resuscitated animals showed a significant decrease in serum potassium levels relative to the baseline value.CONCLUSION:
Hyperkalemia accompanies hemorrhagic shock and, in addition to providing an early sign of the acute ischemic insult severity, may be responsible for cardiac arrest related to hemorrhagic shock.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Réanimation
/
Choc hémorragique
/
Lypressine
/
Hémostatiques
/
Arrêt cardiaque
/
Hyperkaliémie
Limites du sujet:
Animaux
langue:
Anglais
Texte intégral:
Clinics
Thème du journal:
Médicament
Année:
2009
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Universidade de São Paulo/BR
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