Hypokalemia after resuscitation from out-of-hospital ventricular fibrillation.
We studied serum electrolyte levels, blood gas values, and diuretic history in 115 patients immediately after resuscitation from out-of-hospital ventricular fibrillation. Comparisons were made with 84 patients admitted for acute myocardial infarction and with 88 ambulatory patients with coronary heart disease. Admission serum potassium values of 3.60 mEq/L or lower were found in 56 (49%) of the resuscitated patients, compared with 16 (19%) and eight (9%) of the comparison groups, respectively. In the resuscitated patients, the mean serum potassium level was 3.70 +/- 0.72 (SD) mEq/L, compared with 4.09 +/- 0.66 and 4.17 +/- 0.35 mEq/L in the respective comparison groups. Reduced serum potassium concentration was not related to simple extracellular alkalosis. However, the absence of a causative relationship to diuretic use suggested that it occurred during cardiac arrest and resuscitation. Rapid correction of extracellular acidosis by bicarbonate therapy and ventilation may have produced a shift of extracellular potassium into the intracellular compartment even in the absence of extracellular alkalosis.
D001639:Bicarbonates / Q000627:therapeutic use; D003327:Coronary Disease / Q000097:blood; D004232:Diuretics / Q000627:therapeutic use; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D007008:Hypokalemia / Q000209:etiology*; D009203:Myocardial Infarction / Q000097:blood; D011188:Potassium / Q000097:blood / Q000378:metabolism; D012121:Respiration, Artificial; D012151:Resuscitation; D014693:Ventricular Fibrillation / Q000628:therapy*
D001639:Bicarbonates; D004232:Diuretics; D011188:Potassium