Sanjay O P
Department of Anesthesiology, St. John's Medical College Hospital, 560034 Bangalore, Kamataka India.
Indian J Clin Biochem. 2004 Jan;19(1):40-4. doi: 10.1007/BF02872387.
Although potassium is critical for normal electro physiology, the associations between pre-operative serum potassium level and peri-operative adverse events such as arrhythmias in cardiac surgery have not been examined in detail.The objective of this study was to determine the prevalence of abnormal pre-operative serum potassium levels and whether such levels were associated with adverse peri-operative events in 50 patients undergoing coronary artery bypass grafting. Intra-operative and post-operative arrhythmias, the need for cardio-pulmonary resuscitation, cardiac death and death due to any cause prior to discharge from the post-operative intensive care unit were studied. The incidence for adverse outcome was 0.5% for death, 0.5% for cardiac death and 2% for cardio pulmonary resuscitation in patients with hypokalemia (serum potassium level <3.5 meq. L(-1)). Hypokalemia was found to be a predictor of serious peri-operative (OR:2.2; 95% Cl: 1.2-4.1) and post-operative arrhythmias (OR: 1.7;95%Cl: 1.0-2.7).Pre-operative potassium repletion is low cost and low risk treatment measure and the data from this study suggests that screening and repletion be considered in patients scheduled for cardiac surgery.
尽管钾对于正常的电生理功能至关重要,但术前血清钾水平与心脏手术中诸如心律失常等围手术期不良事件之间的关联尚未得到详细研究。本研究的目的是确定50例行冠状动脉搭桥术患者术前血清钾水平异常的发生率,以及这些水平是否与围手术期不良事件相关。研究了术中及术后心律失常、心肺复苏需求、心脏死亡以及术后重症监护病房出院前因任何原因导致的死亡情况。低钾血症(血清钾水平<3.5 meq.L(-1))患者的不良结局发生率为:死亡0.5%,心脏死亡0.5%,心肺复苏2%。低钾血症被发现是严重围手术期(比值比:2.2;95%置信区间:1.2 - 4.1)和术后心律失常(比值比:1.7;95%置信区间:1.0 - 2.7)的一个预测因素。术前补钾是一种低成本、低风险的治疗措施,本研究的数据表明,对于计划进行心脏手术的患者应考虑进行筛查和补钾。