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- Title
Hyperkalemia. A prognostic factor during acute severe hypothermia.
- Authors
Schaller, Marie-Denise; Fischer, Adam P.; Perret, Claude H.; Schaller, M D; Fischer, A P; Perret, C H
- Abstract
When hypothermic patients appear to be dead, the decision to resuscitate may be difficult due to lack of reliable criteria of death. To discover useful prognostic indicators, we reviewed the hospital charts of nine hypothermic victims of snow avalanches (group A: median value of rectal temperature, 29.6 degrees C; range, less than 12 degrees C to 34 degrees C) and of 15 patients with hypothermia following acute drug intoxication and/or cold exposure (group B: 28.8 degrees C; range, 25.5 degrees C to 32 degrees C. In group A, plasma potassium level on admission was extremely high (14.5 mmol/L; range, 6.8 to 24.5 mmol/L) compared with that obtained in group B (3.5 mmol/L; range, 2.7 to 5.3 mmol/L). All patients in group A were in cardiorespiratory arrest. None could be successfully resuscitated despite effective rewarming by cardiopulmonary bypass or peritoneal lavage. In contrast, all of the patients in group B recovered from hypothermia, including two in cardiorespiratory arrest. Thus, extreme hyperkalemia during acute hypothermia appears to be a reliable marker of death. It might be used to select those patients in whom heroic resuscitation efforts can be useful.
- Subjects
HYPOTHERMIA; PROGNOSIS; CARDIAC arrest; THERAPEUTICS; HYPOTHERMIA treatment; RESUSCITATION; THERMOTHERAPY; MEDICAL triage; RETROSPECTIVE studies; ACUTE diseases; HYPERKALEMIA; DISEASE complications
- Publication
JAMA: Journal of the American Medical Association, 1990, Vol 264, Issue 14, p1842
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.1990.03450140064035