Disorders of potassium homeostasis in critically ill patients.
Disorders of potassium homeostasis can be life-threatening. This is especially true in critically-ill patients, in whom concurrent disorders may exacerbate the adverse effects of both hyper- and hypokalemia. Alterations in potassium balance are usually multifunctional in origin. Four broad categories encompass the most common diseases and syndromes seen in the intensive care setting: pharmacologic agents, acid-base disturbances, hypomagnesemia, and renal insufficiency. The various influences that disturb the serum potassium concentration may either potentiate or counter-balance one another. The most important clinical manifestations of disorders of potassium homeostasis are those involving the heart: both hyper- and hypokalemia can be associated with lethal arrhythmias. Neuromuscular, renal and metabolic effects are also seen. Severe hyper- and hypokalemia, irrespective of cause, should be treated as medical emergencies.
Weisberg
L S
LS
Veterans Administration Medical Center, Philadelphia, Pennsylvania.
Szerlip
H M
HM
Cox
M
M
D000137:Acid-Base Imbalance / Q000150:complications; D003422:Critical Care; D006801:Humans; D006947:Hyperkalemia / Q000150:complications / Q000209:etiology / Q000378:metabolism* / Q000628:therapy; D007008:Hypokalemia / Q000150:complications / Q000209:etiology / Q000378:metabolism* / Q000628:therapy; D007674:Kidney Diseases / Q000150:complications; D008275:Magnesium Deficiency / Q000150:complications; D014882:Water-Electrolyte Balance