Document Detail


The overstated risk of preoperative hypokalemia.
MedLine Citation:
PMID:  3341565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To examine the relation between preoperative hypokalemia and frequency of intraoperative arrhythmias, Holter monitoring was employed in 447 patients undergoing major cardiac or vascular operations, the group at greatest risk for life-threatening arrhythmias. Based on serum potassium levels measured immediately before surgery, 57% of patients were normokalemic (greater than or equal to 3.6 mEq/L), 34% hypokalemic (3.1-3.5 mEq/L), and 9% severely hypokalemic (less than or equal to 3.0 mEq/L). No arrhythmia occurred at any time in 63% of patients and minor arrhythmias (premature atrial and occasional premature ventricular contractions) occurred in 16%. Frequent or complex ventricular ectopy appeared before and during operation in 92 patients (21%) but was not related to preoperative potassium level or history of long-term diuretic therapy. Frequent and complex ventricular arrhythmias were more common in patients with a history of long-term digoxin therapy or congestive heart failure. Even among these patients, hypokalemia or diuretic therapy did not increase the incidence or severity of ectopy. These data fail to support the common practice of delaying operation for acute potassium replacement in patients whose preoperative serum potassium is less than normal, even in the presence of cardiovascular disease.
Authors:
I A Hirsch; D L Tomlinson; S Slogoff; A S Keats
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  67     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1988 Feb 
Date Detail:
Created Date:  1988-03-07     Completed Date:  1988-03-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  131-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Anesthesiology, Texas Heart Institute, Houston 77025.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General
Arrhythmias, Cardiac / etiology*
Cardiovascular Diseases / drug therapy,  surgery*
Chronic Disease
Digoxin / therapeutic use
Diuretics / adverse effects
Female
Humans
Hypokalemia / chemically induced,  complications
Intraoperative Complications / etiology*
Male
Potassium / blood*
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Diuretics; 20830-75-5/Digoxin; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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