title: Effects of alkalinization and rehydration on plasma potassium concentrations in neonatal calves with diarrhea.
abstract: BACKGROUND
  Increased plasma potassium concentrations (K(+)) in neonatal calves with diarrhea are associated with acidemia and severe clinical dehydration and are therefore usually corrected by intravenous administration of fluids containing sodium bicarbonate.
  
  
  OBJECTIVE
  To identify clinical and laboratory variables that are associated with changes of plasma K(+) during the course of treatment and to document the plasma potassium-lowering effect of hypertonic (8.4%) sodium bicarbonate solutions.
  
  
  METHODS
  Seventy-one neonatal diarrheic calves.
  
  
  METHODS
  Prospective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate (250-750 mmol), 0.9% saline (5-10 L), and 40% dextrose (0.5 L) infusion solutions.
  
  
  RESULTS
  Infusions with 8.4% sodium bicarbonate solutions in an amount of 250-750 mmol had an immediate and sustained plasma potassium-lowering effect. One hour after the end of such infusions or the start of a sodium bicarbonate containing constant drip infusion, changes of plasma K(+) were most closely correlated to changes of venous blood pH, plasma sodium concentrations and plasma volume (r = -0.73, -0.57, -0.53; P < .001). Changes of plasma K(+) during the subsequent 23 hours were associated with changes of venous blood pH, clinical hydration status (enophthalmos) and serum creatinine concentrations (r = -0.71, 0.63, 0.62; P < .001).
  
  
  CONCLUSIONS
  This study emphasizes the importance of alkalinization and the correction of dehydration in the treatment of hyperkalemia in neonatal calves with diarrhea.
authors: Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, LMU Munich, Oberschleißheim, Germany.
authors: F M
authors: FM
authors: Trefz
authors: A
authors: A
authors: Lorch
authors: J
authors: J
authors: Zitzl
authors: A
authors: A
authors: Kutschke
authors: G
authors: G
authors: Knubben-Schweizer
authors: I
authors: I
authors: Lorenz
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D002417:Cattle; D002418:Cattle Diseases / Q000097:blood*; D003967:Diarrhea / Q000628:therapy / Q000662:veterinary*; D005440:Fluid Therapy / Q000662:veterinary*; D006863:Hydrogen-Ion Concentration; D016014:Linear Models; D015999:Multivariate Analysis; D011188:Potassium / Q000097:blood*; D017693:Sodium Bicarbonate / Q000494:pharmacology
chemical_list: D017693:Sodium Bicarbonate; D011188:Potassium
keywords: Fluid therapy; Hyperkalemia; Hypertonic sodium bicarbonate; Strong ion metabolic acidosis
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