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Title: Relationship between acute hypercarbia and hyperkalaemia during surgery.
Austin Authors: Weinberg, Laurence ;Russell, Amelia;Mackley, Lois;Dunnachie, Charles;Meyerov, Joshua;Tan, Chong O ;Li, Michael H-G ;Hu, Raymond;Karalapillai, Dharshi 
Affiliation: Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Melbourne Medical School, University of Melbourne, Victoria, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 26-Nov-2019
Publication information: World journal of clinical cases 2019; 7(22): 3711-3717
Abstract: The relationship between hyperkalaemia and metabolic acidosis is well described in the critical care setting; however, the relationship between acute respiratory acidosis and plasma potassium concentration is less well understood. In a controlled model of increasing levels of hypercarbia, we tested the hypothesis of whether increasing levels of hypercarbia are associated with changes in plasma potassium concentrations. To determine whether increasing levels of hypercarbia are associated with changes in plasma potassium concentrations. We performed a post-hoc study examining changes in serum potassium in 24 patients who received increased levels of hypercarbia during cardiac surgery. Arterial blood gases and plasma concentrations of potassium were measured at baseline, 3 min prior to, and then every 3 min for 15 min during the intervention of hypercarbia. The primary endpoint was the absolute change in serum K+ at 15 min compared to the baseline K+ value. The following secondary endpoints were evaluated: (1) The association between CO2 and serum K+ concentration; and (2) The correlation between plasma pH and serum K+ concentrations. During the intervention, PaCO2 increased from 43.6 mmHg (95%CI: 40.1 to 47.1) at pre-intervention to 83.9 mmHg (95%CI: 78.0 to 89.8) at 15 min after intervention; P < 0.0001. The mean (SD) serum potassium increased from 4.16 (0.35) mmol/L at baseline to 4.28 (0.33) mmol/L at 15 min (effect size 0.09 mol/L; P = 0.22). There was no significant correlation between PaCO2 and potassium (Pearson's coefficient 0.06; 95%CI: -0.09 to 0.21) or between pH and potassium (Pearson's coefficient -0.07; 95%CI: -0.22 to 0.09). Acute hypercarbia and subsequent respiratory acidaemia were not associated with hyperkalaemia in patients undergoing major surgery.
DOI: 10.12998/wjcc.v7.i22.3711
ORCID: 0000-0001-7403-7680
Journal: World journal of clinical cases
PubMed URL: 31799295
ISSN: 2307-8960
Type: Journal Article
Subjects: Anaesthesia
Intensive care
Appears in Collections:Journal articles

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