Mégret F, Perrier V, Fleureau C, Germain A, Dewitte A, Rozé H, Ouattara A
Service d'anesthésie-réanimation II, hôpital du Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 3300 Bordeaux, France.
Ann Fr Anesth Reanim. 2012 Oct;31(10):788-92. doi: 10.1016/j.annfar.2012.06.024. Epub 2012 Aug 24.
Evaluate the changes in potassium following rapid sequence induction with succinylcholine in critically ill-patients and determine whether hospital length of stay could influence the succinylcholine-induced hyperkaliemia.
Prospective and observational study.
After approval by our local ethical committee, we prospectively included 36 patients admitted from more than 24hours in ICU and who required succinylcholine for rapid tracheal intubation (1mg/kg). Serum potassium was measured before, 5 and 30min after succinylcholine. The incidence of life-threatening hyperkaliemia (≥6.5mmol/L) was noted.
We could observe significant and transient increase in serum potassium (median increase of 0.45 [0.20-0.80] mmol/L at five minutes). A significant relationship was observed between the ICU length of stay and arterial potassium increase (r=0.37, P<0.05). From the ROC curve, a threshold of 12 days had an 86% sensitivity and 69% specificity in discriminating patients in whom the potassium increase was more than 1.5mmol/L.
Induction with succinylcholine is followed by significant but transient hyperkaliema. The ICU length of stay before giving succinylcholine could influence significantly the amplitude of potassium increase.
评估危重症患者使用琥珀酰胆碱快速序贯诱导后钾的变化，并确定住院时间是否会影响琥珀酰胆碱诱导的高钾血症。
前瞻性观察性研究。
经当地伦理委员会批准后，我们前瞻性纳入了36例入住重症监护病房（ICU）超过24小时且需要使用琥珀酰胆碱进行快速气管插管（1mg/kg）的患者。在使用琥珀酰胆碱前、用药后5分钟和30分钟测量血清钾。记录危及生命的高钾血症（≥6.5mmol/L）的发生率。
我们观察到血清钾显著且短暂升高（5分钟时中位数升高0.45[0.20 - 0.80]mmol/L）。观察到ICU住院时间与动脉血钾升高之间存在显著相关性（r = 0.37，P < 0.05）。根据ROC曲线，12天的阈值在区分血钾升高超过1.5mmol/L的患者时，灵敏度为86%，特异度为69%。
使用琥珀酰胆碱诱导后会出现显著但短暂的高钾血症。使用琥珀酰胆碱前的ICU住院时间可能会显著影响血钾升高的幅度。
