Disorders of Potassium

Schaefer, Timothy J.; Wolford, Robert W.

doi:10.1016/j.emc.2005.03.016

Cited by 125 publications

(112 citation statements)

References 48 publications

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“…Electrocardiography (ECG) changes such as an increase in the amplitude of P-waves, prolongation in PR and QT intervals, decrease in the amplitude of T-waves, inversion in T-waves, depression in ST segments, and the appearance of U-waves are observed as cardiac findings (Figure 1). 11 However, ECG changes may not always correlate with the level of hypokalemia. Left ventricular hypertrophy and heart failure may be detected, and the risks of digoxin toxicity, dysrhythmia, and sudden death increase.…”

Section: Clinical Signs and Symptoms Of Neonatal Hypokalemiamentioning

confidence: 99%

“…10,11 Hypokalemia is usually asymptomatic when K + levels are between 3.0-3.5 mEq/L; however, there may sometimes be a slight muscle weakness. 11 Moderate hypokalemia is observed when serum K + is between 2.5-3.0 mEq/L. Proximal muscle weakness is observed most commonly in lower extremities; cranial muscles are normal, but constipation and distention are prominent.…”

Section: Clinical Signs and Symptoms Of Neonatal Hypokalemiamentioning

confidence: 99%

“…If urinary Cl -level is below 10 mEq/L, gastrointestinal losses (vomiting, pyloric stenosis, drainage, fistulas, ileostomy, diarrhea, and chloridorrhea) should be considered. 11,13 In babies with a urinary Cl -level above 20 mEq/L, diuretic use and Bartter and Gitelman syndromes should be considered.…”

Section: Evaluation Of Neonatal Hypokalemiamentioning

confidence: 99%

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Neonatal hypokalemia

Sarıcı¹,

Sarici²

2012

RRN

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Abstract:In this article, distribution of potassium (K + ) in body fluids, pathophysiology, causes, clinical signs and symptoms, and the evaluation and treatment of neonatal hypokalemia are reviewed. K + is the most important intracellular cation and normal serum K + is stabilized between 3.5 and 5.5 mEq/L. Hypokalemia may be caused by increased renal losses, increased extrarenal (gastrointestinal) losses, redistribution or prolonged insufficient K + intake. Clinical signs and symptoms occur as the result of functional changes in striated muscle, smooth muscle, and the heart. Hypokalemia is usually asymptomatic when K + levels are between 3.0 and 3.5 mEq/L; however, there may sometimes be slight muscle weakness. Moderate hypokalemia is observed when serum K + is between 2.5 and 3.0 mEq/L. Proximal muscle weakness is observed most commonly in lower extremities; cranial muscles are normal, but constipation and distention are prominent. Severe hypokalemia develops when serum K + falls below 2.5 mEq/L. Rhabdomyolysis, myoglobinuria, severe muscle weakness, paralysis, respiratory distress, and respiratory arrest are observed. The clinical signs and symptoms may be unremarkable in cases of chronically developing hypokalemia; however, appropriate treatment is essential when serum K + level falls below 2.5 mEq/L as the most dangerous complication of hypokalemia is fatal cardiac arrythmia, and changes visible with electrocardiography may not always correlate with the level of hypokalemia. Sodium (Na + ), K + , chloride (Cl -), bicarbonate, creatinine, blood sugar, magnesium (Mg), plasma renin activity, aldosterone, and blood gases should be investigated by laboratory testing. Aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and creatinine kinase isoenzyme MB should be studied if rhabdomyolysis is suspected. In urine sample density, pH, Naand myoglobinuria (blood reaction is positive in the absence of erythrocytes on microscopic examination of urine) should be investigated. The primary aim of therapy is to prevent and treat life-threatening cardiac and muscular complications. However, in the presence of severe symptomatic hypokalemia and gastrointestinal problems such as ileus, the intravenous route may be used in cases where serum K + level is usually below 2.6 mEq/L. K + given in intravenous fluids should not exceed 40 mEq/L. In case of emergency, 0.3-1 mEq/kg of K + may be given intravenously over 1 hour. When higher concentrations (60-80 mEq/L) are needed, infusion through a central vein under electrocardiography monitoring may be used.

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Section: Clinical Signs and Symptoms Of Neonatal Hypokalemiamentioning

confidence: 99%

Section: Clinical Signs and Symptoms Of Neonatal Hypokalemiamentioning

confidence: 99%

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Neonatal hypokalemia

Sarıcı¹,

Sarici²

2012

RRN

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“…When levels reach 8 to 10 mmol/L, asystole or fibrillation may occur. 2 Pseudohyperkalemia can be attributed to sampling conditions and technique, and transport and processing prior to analysis. The underlying mechanisms include contamination, cell damage and metabolic changes.…”

Section: Case Historymentioning

confidence: 99%

Pseudohyperkalemia in a patient with chronic myeloid leukaemia

Jacobsz

Frantzen

2007

South African Family Practice

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“…[16][17][18][19][20][21] Patients with diabetes and renal insufficiency are considered to be at greatest risk of hyperkalemia. 17,[20][21][22][23][24][25] Widespread agreement exists that serum potassium monitoring is a component of good clinical care for patients prescribed RAAS inhibitors. However, available monitoring guidelines are based on opinion, provide varying suggested monitoring frequencies and timing, and are not tailored to patient-specific risks.…”

Section: Background and Objectivesmentioning

confidence: 99%