processing.... Drugs & Diseases > Nephrology Hyperkalemia Updated: Dec 14, 2021 Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN more...
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Background Pathophysiology Etiology Epidemiology Prognosis Show All Presentation History
Physical Examination Show All DDx Workup Approach Considerations
Potassium Assay Electrocardiography Kidney Function Determination Urine Potassium, Sodium, and Osmolality Trans-Tubular Potassium Gradient Show All Treatment Approach Considerations
Initial Emergency Management Pharmacologic Therapy and Dialysis Surgical Therapy Complications of Treatment Diet and Activity Prevention Consultations Long-Term Monitoring Show All Medication Medication Summary
Calcium salts Beta-adrenergic agonists Antidiabetics, Insulins Diuretics, Loop Potassium Binders Alkalinizing Agents Electrolytes Show All Questions & Answers Media Gallery Tables References Overview Practice Essentials Hyperkalemia is defined as a serum potassium concentration greater than approximately 5.0-5.5 mEq/L in adults; the range in infants and children is age-dependent. Levels higher than 7 mEq/L can lead to significant hemodynamic and neurologic consequences; levels exceeding 8.5 mEq/L can cause respiratory paralysis or cardiac arrest and can quickly be fatal. See the image below.
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Blood samples, used for the analysis of bio-ADM, were collected on ICU admission and then centrifuged, aliquoted, frozen, and stored in the SWECRIT biobank at Region Scania (BD-47, SC-1922). Samples collected later than 6 h after ICU admission were excluded. If the sampling time was missing, samples were included if the time of freezing was within 6 h. Frozen plasma samples were shipped, and batch analysis of bio-ADM was performed on thawed samples in March 2019 at the laboratory of SphingoTec GmbH (Hennigsdorf, Germany). The assay has previously been described elsewhere [35].
We would like to thank all staff at the ICUs of Skåne University Hospital in Malmö and Lund, Helsingborg Hospital and Kristianstad Hospital for their contribution to this study. We also extend special thanks to Professor Peter Nilsson of Lund University. This study would not have been possible without the kind contribution of SphingoTec GmbH who analysed our blood samples free of charge.
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However, in the setting of postoperative cardiac surgery, the above described classical forms of waveforms and hemodynamic patterns may not be present during tamponade. The specific location of well-defined hematomas, rather than free mobile accumulation of fluid, determines the specific combination of alterations in waveforms, pressures, and volumes. For example, compression of the RV free wall by a localized hematoma may cause low RVEDV and low continuous cardiac index (CCI), despite substantial fluid administration, in combination with elevated or normal CVP (Table 2).
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