Buse, Sarah, Blancher, Marc, Viglino, Damien, Pasquier, Mathieu, Maignan, Maxime ORCID: 0000-0002-4301-4213, Bouzat, Pierre ORCID: 0000-0003-4667-6738, Annecke, Thorsten ORCID: 0000-0002-2496-4432 and Debaty, Guillaume ORCID: 0000-0003-2879-0326 (2017). The impact of hypothermia on serum potassium concentration: A systematic review. Resuscitation, 118. S. 35 - 43. CLARE: ELSEVIER IRELAND LTD. ISSN 1873-1570

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Abstract

Background: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories. Methods: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. The search strategy included studies related to hypothermia and potassium levels. The relevant literature on clinical studies and experimental studies was reviewed by the authors. Results: Among the 50 studies included in the review, 39 (78%) reported a decrease in blood potassium levels upon hypothermia onset. Hypothermic hypokalaemia is linked to an intracellular shift rather than an actual net loss. The intracellular shift is caused by a variety of factors such as enhanced functioning of Na + K + ATPase, beta-adrenergic stimulation, pH and membrane stabilisation in deep hypothermia. In contrast, hypothermia can act as an aggravating factor in severe trauma with hyperkalaemia being an indicator of an irreversible state of cell death. An increase in the blood potassium level during hypothermia may result from a lack of enzyme functioning at cold temperatures and blocked active transport. Conclusion: Hypothermia causes an initial decrease of potassium levels; however, the final stage of hypothermic cardiac arrest can induce hyperkalaemia due to cell lysis and final depolarisation. Better understanding the physiopathology of potassium levels during accidental hypothermia could be critically important to better select patients who could benefit from aggressive resuscitation therapy such as extracorporeal cardiopulmonary resuscitation. (C) 2017 Elsevier B.V. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Buse, SarahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blancher, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Viglino, DamienUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pasquier, MathieuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maignan, MaximeUNSPECIFIEDorcid.org/0000-0002-4301-4213UNSPECIFIED
Bouzat, PierreUNSPECIFIEDorcid.org/0000-0003-4667-6738UNSPECIFIED
Annecke, ThorstenUNSPECIFIEDorcid.org/0000-0002-2496-4432UNSPECIFIED
Debaty, GuillaumeUNSPECIFIEDorcid.org/0000-0003-2879-0326UNSPECIFIED
URN: urn:nbn:de:hbz:38-220506
DOI: 10.1016/j.resuscitation.2017.07.003
Journal or Publication Title: Resuscitation
Volume: 118
Page Range: S. 35 - 43
Date: 2017
Publisher: ELSEVIER IRELAND LTD
Place of Publication: CLARE
ISSN: 1873-1570
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SEVERE ACCIDENTAL HYPOTHERMIA; CARDIAC-ARREST; EXTRACELLULAR POTASSIUM; THERAPEUTIC HYPOTHERMIA; CIRCULATORY ARREST; HEMORRHAGIC-SHOCK; ION ACTIVITY; RESUSCITATION; TEMPERATURE; HYPOXIAMultiple languages
Critical Care Medicine; Emergency MedicineMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/22050

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