Seck M, Bruder N, Courtinat C, Pellissier D, François G
Département d'anesthésie-réanimation, CHU adulte La Timone, Marseille, France.
Ann Fr Anesth Reanim. 1996;15(2):204-6. doi: 10.1016/0750-7658(96)85046-5.
We report a case of a severe hypokalaemia by intracellular shift of potassium in a sedated and ventilated head trauma patient. The kalaemia which was 3.9 mmol.L-1 at admission in the intensive care unit decreased to 1.3 mmol.L-1 during a perfusion of noradrenaline (0.3 micrograms.kg-1.min-1). Following the decrease of the noradrenaline dose, and administration of potassium, the kalaemia rapidly increased to 5.3 mmol.L-1 carrying a risk of arrhythmia. Therefore, kalaemia and ECG should be closely monitored when the noradrenaline doses are reduced. The causes of transcellular shift of potassium are reviewed.
我们报告了一例在接受镇静和机械通气的头部创伤患者中,因钾离子向细胞内转移而导致严重低钾血症的病例。该患者在重症监护病房入院时血钾浓度为3.9 mmol.L-1,在输注去甲肾上腺素(0.3微克.千克-1.分钟-1)期间降至1.3 mmol.L-1。在减少去甲肾上腺素剂量并补充钾后,血钾迅速升至5.3 mmol.L-1,存在心律失常风险。因此,在降低去甲肾上腺素剂量时,应密切监测血钾浓度和心电图。本文对钾离子细胞内转移的原因进行了综述。