Title
Postoperative hyperkalemia
Abbreviated Journal Title
Eur. J. Intern. Med.
Keywords
Hyperkalemia; Postoperative; Rhabdomyolysis; Transfusions; Drug adverse; effect; ADRENERGIC MODULATION; HOSPITALIZED-PATIENTS; POTASSIUM METABOLISM; RENAL-FAILURE; RHABDOMYOLYSIS; THERAPY; SURGERY; REPLACEMENT; INFUSION; RISK; Medicine, General & Internal
Abstract
Hyperkalemia occurs frequently in hospitalized patients and is of particular concern for those who have undergone surgery, with postoperative care provided by clinicians of many disciplines. This review describes the normal physiology and how multiple perioperative factors can disrupt potassium homeostasis and lead to severe elevations in plasma potassium concentration. The pathophysiologic basis of diverse causes of hyperkalemia was used to broadly classify etiologies into those with altered potassium distribution (e.g. increased potassium release from cells or other transcellular shifts), reduced urinary excretion (e.g. reduced sodium delivery, volume depletion, and hypoaldosteronism), or an exogenous potassium load (e.g. blood transfusions). Surgical conditions of particular concern involve: rhabdomyolysis from malpositioning, trauma or medications; bariatric surgery; vascular procedures with tissue ischemia; acidosis; hypovolemia; and volume or blood product resuscitation. Certain acute conditions and chronic co-morbidities present particular risk. These include chronic kidney disease, diabetes mellitus, many outpatient preoperative medications (e.g. beta blockers, salt substitutes), and inpatient agents (e.g. succinylcholine, hyperosmolar volume expanders). Clinicians need to be aware of these pathophysiologic mechanisms for developing perioperative hyperkalemia as many of the risks can be minimized or avoided. (C) 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Journal Title
European Journal of Internal Medicine
Volume
26
Issue/Number
2
Publication Date
1-1-2015
Document Type
Review
Language
English
First Page
106
Last Page
111
WOS Identifier
ISSN
0953-6205
Recommended Citation
"Postoperative hyperkalemia" (2015). Faculty Bibliography 2010s. 6407.
https://stars.library.ucf.edu/facultybib2010/6407
Comments
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