Weisberg Lawrence S
Division of Nephrology, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, Cooper University Hospital, Camden, NJ, USA.
Crit Care Med. 2008 Dec;36(12):3246-51. doi: 10.1097/CCM.0b013e31818f222b.
Hyperkalemia is one of the few potentially lethal electrolyte disturbances. Prompt recognition and expeditious treatment of severe hyperkalemia are expected to save lives. This review is intended to provide intensivists and other interested clinicians with an understanding of the pathophysiology that underlies hyperkalemia, and a rational approach to its management.
This article reviews and analyzes literature relevant to the pathophysiology and management of severe hyperkalemia. Methods include search of MEDLINE, and bibliographic search of current textbooks and journal articles.
A more complete understanding of potassium homeostasis in recent years has led to new approaches to the management of severe hyperkalemia. The physiologically based sequential approach still applies. The efficacy, pitfalls, and risks of the agents available for use at each step in the sequence are critically reviewed. Rational use of the available tools will allow clinicians to successfully treat severe hyperkalemia.
高钾血症是少数几种具有潜在致命性的电解质紊乱之一。迅速识别并及时治疗严重高钾血症有望挽救生命。本综述旨在让重症监护医生和其他感兴趣的临床医生了解高钾血症的病理生理学基础以及合理的处理方法。
本文回顾并分析了与严重高钾血症的病理生理学和处理相关的文献。方法包括检索医学文献数据库（MEDLINE），以及对当前教科书和期刊文章进行文献检索。
近年来对钾稳态有了更全面的认识，从而产生了治疗严重高钾血症的新方法。基于生理学的序贯治疗方法仍然适用。对该治疗顺序中每一步可用药物的疗效、缺陷和风险进行了严格审查。合理使用现有工具将使临床医生能够成功治疗严重高钾血症。
