Hyperkalemia. A prognostic factor during acute severe hypothermia.

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Version: Final published version
Serval ID
serval:BIB_DE08F913C820
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Hyperkalemia. A prognostic factor during acute severe hypothermia.
Journal
Jama : the Journal of the American Medical Association
Author(s)
Schaller M.D., Fischer A.P., Perret C.H.
ISSN
0098-7484 (Print)
ISSN-L
0098-7484
Publication state
Published
Issued date
1990
Volume
264
Number
14
Pages
1842-1845
Language
english
Abstract
When hypothermic patients appear to be dead, the decision to resuscitate may be difficult due to lack of reliable criteria of death. To discover useful prognostic indicators, we reviewed the hospital charts of nine hypothermic victims of snow avalanches (group A: median value of rectal temperature, 29.6 degrees C; range, less than 12 degrees C to 34 degrees C) and of 15 patients with hypothermia following acute drug intoxication and/or cold exposure (group B: 28.8 degrees C; range, 25.5 degrees C to 32 degrees C. In group A, plasma potassium level on admission was extremely high (14.5 mmol/L; range, 6.8 to 24.5 mmol/L) compared with that obtained in group B (3.5 mmol/L; range, 2.7 to 5.3 mmol/L). All patients in group A were in cardiorespiratory arrest. None could be successfully resuscitated despite effective rewarming by cardiopulmonary bypass or peritoneal lavage. In contrast, all of the patients in group B recovered from hypothermia, including two in cardiorespiratory arrest. Thus, extreme hyperkalemia during acute hypothermia appears to be a reliable marker of death. It might be used to select those patients in whom heroic resuscitation efforts can be useful.
Keywords
Acute Disease, Adolescent, Adult, Female, Heart Arrest/therapy, Humans, Hyperkalemia/etiology, Hyperthermia, Induced, Hypothermia/complications, Hypothermia/therapy, Male, Middle Aged, Prognosis, Resuscitation, Retrospective Studies, Triage
Pubmed
Web of science
Create date
06/09/2011 17:43
Last modification date
20/08/2019 16:02
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