Hyperkalemia accompanies hemorrhagic shock and correlates with mortality
Clinics
; 64(6): 591-597, June 2009. graf
Article
in English
| LILACS
| ID: lil-517930
Responsible library:
BR1.1
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.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
/
Endocrine System Diseases
Database:
LILACS
Main subject:
Resuscitation
/
Shock, Hemorrhagic
/
Lypressin
/
Hemostatics
/
Heart Arrest
/
Hyperkalemia
Limits:
Animals
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2009
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de São Paulo/BR