Part 10.1: Life-Threatening Electrolyte Abnormalities

  title={Part 10.1: Life-Threatening Electrolyte Abnormalities},
  author={Lippincott Williams Wilkins},
  • L. Wilkins
  • Published 13 December 2005
  • Medicine
  • Circulation
Electrolyte abnormalities are commonly associated with cardiovascular emergencies. These abnormalities may cause or contribute to cardiac arrest and may hinder resuscitative efforts. In some cases therapy for life-threatening electrolyte disorders should be initiated before laboratory results become available. The magnitude of the potassium gradient across cell membranes determines excitability of nerve and muscle cells, including the myocardium. Rapid or significant changes in the serum… 
28 Citations

Marked Symptomatic Bradycardia Associated with Profound

Life-threatening hyperkalemia should be suspected in any patient with acute onset bradycardia who presents to the emergency department and blood potassium concentration should be determined immediately by rapid point-of-care tests for an early diagnosis and appropriate medical treatment.

Disorders of potassium homeostasis: pathophysiology and management.

This article aims to provide a clinically relevant update on management of potassium disorders for internists.

Potassium-lowering agents for the treatment of nonemergent hyperkalemia: pharmacology, dosing and comparative efficacy.

  • M. B. BridgemanMilisha ShahE. Foote
  • Medicine, Biology
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2019
An evaluation of the characteristics of cation-exchange resins, polymers or other novel mechanisms of potassium trapping, including sodium polystyrene sulfonate, patiromer and sodium zirconium cyclosilicate in the management of nonemergent hyperkalemia will be explored.

Mechanisms and management of drug-induced hyperkalemia in kidney transplant patients

Patiromer and sodium zirconium cyclosilicate may play an important role in the management of chronic hyperkalemia in kidney transplant patients, although additional long-term studies are necessary to confirm these effects.

A Survey Demonstrating Lack of Consensus on the Sequence of Medications for Treatment of Hyperkalemia Among Pediatric Critical Care Providers*

  • N. ChimeXun LuoL. McNamaraA. NishisakiE. Hunt
  • Medicine
    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
  • 2015
This survey revealed notable variability in the choice and sequence of medications for treatment of life-threatening hyperkalemia with surprisingly few participants in compliance with the advanced cardiovascular life support hyperkAlemia guidelines.

Anticoagulation techniques in apheresis: From heparin to citrate and beyond

Oral or intravenous calcium supplementation is advised for decreased ionized calcium levels and/or symptomatic management of hypocalcemia and Heparin‐based anticoagulation is limited to certain apheresis procedures or is used in combination with citrate to reduce citrate load.

Hypoglycemia following intravenous insulin plus glucose for hyperkalemia in patients with impaired renal function

The authors' intravenous regimen combining an infusion of insulin plus glucose effectively reduced serum potassium levels compared to previous studies and associated a low risk of symptomatic hypoglycemia and other complications.

Ionized calcium level at emergency department arrival is associated with return of spontaneous circulation in out-of-hospital cardiac arrest

A high ionized calcium level measured during cardiopulmonary resuscitation was associated with an increased likelihood of ROSC and was not associated with survival discharge or favorable neurologic outcome.

A Female Patient with Recurrent Ventricular Fibrillation Attacks Due to Severe Hypokalemia Induced by Taraxacum Plant Intake

A 33-year old female patient admitted to the intensive care unit (ICU) with cardiac arrest had severe hypokalemia (1.5 mmol/L) observed in blood values, and history obtained from the family revealed that she had consumed 10-15 cup of herb tea daily with dandelion plants for 2 months to strengthen her immune system.



Therapeutic recommendations for management of severe hyponatremia: current concepts on pathogenesis and prevention of neurologic complications.

Patients with hyponatremia are exposed to major neurological complications which potentially leads to subsequent neuropathological sequelae or death, and understanding of brain adaptative mechanisms to changes in osmolality largely contributes to explain these neurological events.

Myelinolysis after Correction of Hyponatremia

The patient had no segmental brain stem signs, and the neurologic deficit was too limited to be explained by thrombosis of the basilar artery itself, so the patient died after 22 days of hospitalization.

Treatment of symptomatic hyponatremia and its relation to brain damage. A prospective study.

It is suggested that this complication does not depend on the rate of correction of hyponatremia, which was associated with demyelination in patients with hepatic encephalopathy.

Outcomes of severe hyperkalemia in cardiopulmonary resuscitation with concomitant hemodialysis

Hemodialysis during CPR is probably an effective adjunct to the treatment of severe hyperkalemia in patients with severe hemodynamic compromise and asystolic cardiac arrest.

Lesson of the Week: Hyperkalaemic cardiac arrest successfully treated with peritoneal dialysis

A patient subsequently shown to have muscular dystrophy who was successfully treated with peritoneal dialysis after conventional pharmacological methods had failed is reported on.

Plasma potassium, serum magnesium and ventricular fibrillation: a prospective study.

Low plasma potassium and magnesium concentrations have been advanced as risk factors for ventricular fibrillation (VF) and for magnesium the evidence shows an association with ventricular arrhythmias but no direct association with VF.

Effect of bicarbonate administration on plasma potassium in dialysis patients: interactions with insulin and albuterol.

  • M. AllonN. Shanklin
  • Medicine, Biology
    American journal of kidney diseases : the official journal of the National Kidney Foundation
  • 1996

Aiding fluid prescription for the dysnatremias

A novel equation based on a simple equation derived from established principles on the distribution of sodium in body fluids provides quantitative projections that can assist the physician in implementing the selected treatment plan for patients with dysnatremias.