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Resuscitative hyperkalemia in noncrush trauma: a prospective, observational study
- Source :
- Clinical journal of the American Society of Nephrology : CJASN. 2(2)
- Publication Year :
- 2007
-
Abstract
- The trauma patient is exposed to physiologic processes and life-saving interventions that predispose to hyperkalemia. Severe elevations in potassium levels subject this compromised patient to additional cardiac risks in the periresuscitative period. Recent advances in the care of the massively traumatized patient may or may not increase the risk for hyperkalemia. This prospective, observational study was undertaken to define the period prevalence of hyperkalemia (plasma potassium levelor = 5.5 mmol/L) in a noncrush trauma population during the initial resuscitative period and to identify potential risk factors for the development of hyperkalemia. A total of 131 patients were studied during the initial 12 h after admission for noncrush trauma. The period prevalence of hyperkalemia was 29.0%. Hyperkalemic patients had dramatic shifts in plasma potassium levels compared with nonhyperkalemic patients. Five patients, all from the hyperkalemic group, died. By multivariate logistic regression analysis, independent risk factors for hyperkalemia were an emergency department plasma potassium level of 4.0 mmol/L or higher (relative risk 3.40; 95% confidence interval 1.17 to 9.84; P = 0.024 versus baseline potassium level4.0 mmol/L) and transfusion of cell- or plasma-based products (relative risk 10.56; 95% confidence interval 3.62 to 30.78; P0.001 per log-transformed unit). The prevalence of hyperkalemia during trauma resuscitation was not reported previously. Given the arrhythmic risks of hyperkalemia, particular caution is necessary with trauma patients who present with plasma potassium levels4.0 mmol/L and require aggressive transfusion support.
- Subjects :
- Adult
Male
medicine.medical_specialty
Resuscitation
Blood transfusion
Hyperkalemia
Epidemiology
medicine.medical_treatment
Population
Critical Care and Intensive Care Medicine
medicine
Prevalence
Humans
Prospective Studies
Intensive care medicine
education
Transplantation
education.field_of_study
business.industry
Emergency department
Confidence interval
Nephrology
Relative risk
Emergency medicine
Wounds and Injuries
Observational study
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 1555905X
- Volume :
- 2
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Clinical journal of the American Society of Nephrology : CJASN
- Accession number :
- edsair.doi.dedup.....4d71bc7fceeba37865c676e1f2e6bd76