The effect of small doses of potassium on postoperative ventricular arrhythmias

Selmonosky, Carlos A.; Flege, John B.

doi:10.1016/s0022-5223(19)43197-8

Cited by 11 publications

(3 citation statements)

References 3 publications

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“…A literature search was carried out using CINAHL, Medline, PubMED and Cochrane Database, with the terms ‘Potassium’, ‘hypokalaemia’, ‘potassium replacement’ and ‘potassium infusion’. Two seminal papers outlined the relationship between hypokalaemia and arrhythmias, particularly ventricular rhythm disturbances nearly 40 years ago (Selmonosky and Flege, 1967; Shanahan et al , 1969). Early papers identified the potential hazards of administering potassium but did not give any advice on replacement infusions (Lawson, 1975; Stanaszek and Romankiewicz, 1985) or speculated on the causes of hypokalaemia (Lindeman, 1976).…”

Section: Methodsmentioning

confidence: 99%

Safely treating hypokalaemia in high dependency cardiac surgical patients

Sladdin

Lee

2006

Nursing in Critical Care

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In Australia, there were national issues on the use of potassium ampoules (resulting in patient deaths), which led to the removal of the ampoules from clinical areas. A decision was made by the Medication Safety Committee at a metropolitan Melbourne hospital to remove potassium ampoules from ward areas as part of the establishment of a hospital-wide potassium guideline. As a result, the nurses in the cardiothoracic ward Practice Review Committee identified the need to review the proposed practice of treating hypokalaemia with 30 mmol of potassium chloride (KCL) in 1000 mL over an extended period in postoperative cardiothoracic patients. The challenge was to develop a practice to safely administer intravenous KCL in fluid restricted patients in addition to the hospital guidelines to prevent hypokalaemic-induced cardiac dysrhythmias. A literature search revealed there were no clear or uniform approaches to guide our practice in addressing this clinical problem. The Practice Review Committee developed a KCL administration guideline based on a review of the available literature. The Practice Review Committee developed a ward-based guideline that addressed infusion concentration, duration of administration, responsiveness of nurses to severity of hypokalaemia and the evaluation of treatment by measuring serum potassium after replacement. This ward-based guideline was based on benchmarking from similar institutions and relevant literature. The review process provided an opportunity for the staff to critique their practice to improve patient care and allowed regular evaluation of the implemented practice guideline. The ward-based guideline required a revision as patients' renal function was not being taken into consideration prior to potassium infusions being administered. The implementation of the ward-based guideline into practice has been well received by the staff as it has allowed consistent practice and timely treatment of hypokalaemia.

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Section: Methodsmentioning

confidence: 99%

Safely treating hypokalaemia in high dependency cardiac surgical patients

Sladdin

Lee

2006

Nursing in Critical Care

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“…Es handelt sich dabei hauptsächlich um Serumelektrolytveränderungen. Intrazelluläre Elektrolytveränderungen sind nur vereinzelt mitgeteilt (18,21,26 (5,10,27).…”

Section: Diskussionunclassified

“…Hier möchten wir Arrhythmie und LOS erwähnen. Einige Herzchirurgen berichteten über eine Korrelation zwischen dem Auftreten der postoperativen Arrhythmie und Hypokaliämie und über therapeutische Effekte der Kalium-Injektion bei einer solchen Arrhythmie (10,17,27).…”

Section: Diskussionunclassified

Klinische Studien des extrakorporalen Kreislaufs mit verstärkter Hämodilution

Ban¹,

Tatsuta²,

Kawai³

et al. 1970

Thorac cardiovasc Surg

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Die offenen Herzoperationen mit Hilfe des extrakorporalen Kreislaufs sind nun zwar zur üblichen Methode geworden, doch wird das Sammeln des frisch entnommenen, heparinisierten Blutes mit steigender Operationszahl immer schwieriger. Einige Herzchirurgen berichteten bereits (5,6,8,9,12,19,20,21,31) über eine meistens hypotherme, vereinfachte Perfusion ohne heparinisiertes Perfusionsblut, welche das Füllvolumen der Herz-Lungen-Maschine vermindert. Bei einer solchen Perfusionsmethode wird das in der Herz-Lungen-Maschine verbliebene, verdünnte Blut nach Ende des Bypass zur Gänze dem Patienten reinfundiert. Dabei ergibt sich die Frage, wieweit die Hämodilution, hauptsächlich vom Standpunkt der Wasserbelastung nach dem Bypass aus, gestattet werden kann. Vom hämodynamischen und metabolischen Standpunkt aus wäre zwar die Hämodilution bei gleichzeitiger Anwendung der Hypothermie noch weiter möglich. Wenn aber das Ausmaß der Hämodilution eine Grenze überschreitet, so wird es unmöglich, das in der Herz-Lungen-Maschine verbliebene Blut wegen zu schwerer Wasserbelastung zur Gänze dem Patient zu reinfundieren. Dabei müßte das in der Herz-Lungen-Maschine verbliebene, patienteneigene Blut nutzlos verworfen werden. Daher wäre es wünschenswert, eine Methode zu entwickeln, dieses Blut einzusparen.

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Literatur

Regensburger¹

1976

Myokarddurchblutung Und Stoffwechselparameter Im Arteriellen Blut Bei Hämodilutionsperfusion

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The effect of small doses of potassium on postoperative ventricular arrhythmias

Cited by 11 publications

References 3 publications

Safely treating hypokalaemia in high dependency cardiac surgical patients

Safely treating hypokalaemia in high dependency cardiac surgical patients

Klinische Studien des extrakorporalen Kreislaufs mit verstärkter Hämodilution

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