Abstract
Samples of blood were taken at five to 10-minute intervals during cooling, circulatory arrest, and rewarming in eight consecutive patients undergoing open cardiac surgery under profound hypothermia at nasopharyngeal and oesophageal temperatures of approximately 10°C. and the serum potassium levels were estimated. Urine samples were also collected from six of the eight patients and the total potassium excretion calculated per minute. It was found that there was a tendency for the serum potassium level to rise towards the end of cooling. A further more significant rise occurred during circulatory arrest, and on rewarming there was a pronounced fall of approximately 2·5 mEq./litre, the lowest level being reached at 27·5°C. Above 27·5°C. there was no further significant change in the serum potassium level. It is suggested that the acidosis which occurs during circulatory arrest and a depression in the function of the cell membrane at very low temperatures are at least partly responsible for the changes in serum potassium. Certainly the excretion of potassium in the urine does not account for them.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- DREW C. E., ANDERSON I. M. Profound hypothermia in cardiac surgery: report of three cases. Lancet. 1959 Apr 11;1(7076):748–750. doi: 10.1016/s0140-6736(59)91825-2. [DOI] [PubMed] [Google Scholar]
- DUNLOP M., CURNOW D. H. Electrolyte changes during profound hypothermia in dogs. Med J Aust. 1962 May 26;49(1):803–806. doi: 10.5694/j.1326-5377.1962.tb26940.x. [DOI] [PubMed] [Google Scholar]
- EVANS E. I. Potassium deficiency in surgical patients; its recognition and management. Ann Surg. 1950 Jun;131(6):945–959. doi: 10.1097/00000658-195006000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
- FREEMAN-NARROD M., GOODFORD P. J. Sodium and potassium content of the smooth muscle of the guinea-pig taenia coli at different temperatures and tensions. J Physiol. 1962 Oct;163:399–410. doi: 10.1113/jphysiol.1962.sp006985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- GOLLAN F., RUDOLPH G. G., OLSEN N. S. Electrolyte transfer during hypothermia and anoxia in dogs. Am J Physiol. 1957 May;189(2):277–280. doi: 10.1152/ajplegacy.1957.189.2.277. [DOI] [PubMed] [Google Scholar]
- HURT R. L. Apparatus for profound hypothermia by the Drew technique. Lancet. 1962 Apr 14;1(7233):783–783. doi: 10.1016/s0140-6736(62)91789-0. [DOI] [PubMed] [Google Scholar]
- KENYON J. R. Experimental deep hypothermia. Br Med Bull. 1961 Jan;17:43–47. doi: 10.1093/oxfordjournals.bmb.a069862. [DOI] [PubMed] [Google Scholar]
- MARKS L. J. Potassium deficiency in surgical patients. Ann Surg. 1950 Jul;132(1):20–35. doi: 10.1097/00000658-195007000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MUNDAY K. A., BLANE G. F., CHIN E. F., MACHELL E. S. Plasma electrolyte changes in hypothermia. Thorax. 1958 Dec;13(4):334–342. doi: 10.1136/thx.13.4.334. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PIZZOFERRATO A., LAMI L. [The action of anesthesia and of surgical operation on the behavior of some plasmatic electrolytes in the orthopedic patient. I. Blood potassium and sodium]. Chir Organi Mov. 1961 Nov;50:410–417. [PubMed] [Google Scholar]
- SARAJAS H. S. Blood glucose and plasma potassium levels in hypothermic dogs. Ann Chir Gynaecol Fenn. 1962;51:253–263. [PubMed] [Google Scholar]
- STAIB I., BERNARD M., KIRCHNER E., MAURATH J., MUELLER K. H. [Electrolyte studies in halothane anesthesia]. Anaesthesist. 1961 Nov;10:330–334. [PubMed] [Google Scholar]
- SWAN H., ZEAVIN I., HOLMES J. H., MONTGOMERY V. Cessation of circulation in general hypothermia. I. Physiologic changes and their control. Ann Surg. 1953 Sep;138(3):360–376. doi: 10.1097/00000658-195313830-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- YONCE L. R., DYKERS J. R., Jr, McGEE J. W. Vascular resistance and venous blood K ions during hypothermia in skeletal muscle. Am J Physiol. 1962 Feb;202:277–280. doi: 10.1152/ajplegacy.1962.202.2.277. [DOI] [PubMed] [Google Scholar]