Javdan Zahra, Talakoub Reihanak, Honarmand Azim, Golparvar Mohammad, Farsani Enayatolah Yadollahi
Department of Anesthesiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Anesthesiology, School of Medicine, Anesthesia and Critical Care Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2015 Jul 27;4:133. doi: 10.4103/2277-9175.161525. eCollection 2015.
No previous study has been done to evaluate the admission serum potassium level as a predictor of morbidity or need for mechanical ventilation. The aim of this study is to determine the predictive ability of serum potassium on admission, in critically ill trauma patients, and to evaluate the relation of the potassium level to organ failure, length of stay, ventilator need, and duration of mechanical ventilation.
A prospective, observational study was done on 100 patients >16 years old, admitted to the Medical-Surgical Intensive Care Units (ICU), for over one year. Patients were classified into Group A: Patients who required equal or less than five days of mechanical ventilation and Group B: Patients who required more than five days of mechanical ventilation. The total serum potassium concentrations were measured and the Sequential Organ Failure Assessment (SOFA) score was recorded at the time of admission to the ICU, when connected to the ventilator, and then at the time of weaning from the ventilator.
There was no significant difference between the Serum K concentrations between the two groups, on admission. However, there were significant difference between the Serum K concentrations at times of receiving and weaning from mechanical ventilation (MV) between the two groups. We found the best cut-off point of 3.45 for serum potassium concentration, to predict the need for longer duration of MV.
Development of hypokalemia during an ICU stay is associated with the need for mechanical ventilation. Monitoring of the serum potassium levels may be a good prognostic factor for the requirement of mechanical ventilation.
此前尚无研究评估入院时血清钾水平作为发病或机械通气需求预测指标的情况。本研究旨在确定重症创伤患者入院时血清钾的预测能力，并评估钾水平与器官衰竭、住院时间、通气需求及机械通气时长之间的关系。
对100名16岁以上入住外科重症监护病房（ICU）超过一年的患者进行了一项前瞻性观察性研究。患者被分为A组：机械通气时间等于或少于5天的患者；B组：机械通气时间超过5天的患者。在入住ICU时、连接呼吸机时以及脱机时测量血清总钾浓度，并记录序贯器官衰竭评估（SOFA）评分。
两组患者入院时血清钾浓度无显著差异。然而，两组患者在接受机械通气和脱机时的血清钾浓度存在显著差异。我们发现血清钾浓度的最佳截断值为3.45，以预测机械通气时长。
ICU住院期间低钾血症的发生与机械通气需求相关。监测血清钾水平可能是机械通气需求的一个良好预后因素。
