The goals of therapy are a reduction of the serum potassium level coupled with a stabilization of the myocardial cell membrane. The resuscitative management of hyperkalemia (see Table 2) is guided in large part by the patient’s clinical situation, including the electrocardiographic findings in fact, the ECG should guide both the urgency as well as the magnitude of therapy. Patients 2-5 in fact, the ECG may appear normal, non-specifically abnormal, or may reveal unusualĪbnormalities such as a heart block and bundle branch block.įigure 2. Furthermore, the electrocardiogram (ECG) may not demonstrate classic abnormality in all 1 (See Table 1.) Significant variation may be found among patients at any particular serum potassium The expected progression of electrocardiographic changes associated with hyperkalemia is wellĭescribed. The electrocardiographic manifestations of hyperkalemia may involve all phases of the cardiac impulse. Hyperkalemia also frequently is encountered in patients with renal failure (both acute and chronic) diabetic ketoacidosis and other acidotic states digoxin toxicity type IV renal tubular acidosis and medication-related issues (agents that affect kidney function or the renal reclamation of potassium). The most common cause is red blood cell hemolysis, which occurs after the patient’s blood sample has been obtained. The spectrum of clinical presentation is wide, ranging from asymptomatic laboratory discovery to cardiac arrest. Hyperkalemia is an electrolyte disorder with life-threatening potential. Hyperkalemia: Electrocardiographic Recognition and Initial Therapeutic Considerations
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