Does hypothermia cause hypokalemia?
Severe hypokalemia may be seen in hypothermic patients, which represents a shift of potassium rather than a true loss. Careful management of this electrolyte problem must be given to avoid hyperkalemia with rewarming.
Why does potassium drop in hypothermia?
We conclude that hypothermia produces hypokalemia by a shift of potassium from the extracellular to intracellular or extra vascular spaces. Potassium therapy during controlled hypothermia in the range 30 degrees – 32 degrees C should only replace measured losses.
Does hypothermia increase potassium?
An increase in the blood potassium level during hypothermia may result from a lack of enzyme functioning at cold temperatures and blocked active transport.
What electrolyte complication may develop during the rewarming phase of therapeutic hypothermia?
Rewarming phase Warming the patient too quickly or allowing continued shivering causes dangerous electrolyte shifts, leading to potentially lethal arrhythmias. Controlled rewarming of 0.15° to 0.5° C per hour is recommended.
What happens to potassium during rewarming?
During rewarming, serum potassium increased, with 15% reaching values of >5.5 mmol/L. Potassium supplementation was initiated at 3.5 mmol/L (quartiles 3.2-3.6 mmol/L) and stopped at 4.5 mmol/L (4.1-4.8 mmol/L).
How is therapeutic hypothermia induced?
In general, two methods of induced hypothermia are used currently: surface cooling and endovascular cooling. Surface cooling methods include convective air blankets, water mattresses, alcohol bathing, cooling jackets, and ice packing. Surface cooling techniques have been used for many years in the treatment of fever.
Does rewarming cause hypotension?
Hypotension — Patients with moderate or severe hypothermia frequently become disproportionately hypotensive during rewarming due to severe dehydration and fluid shifts [10,22,24]. Two large (14- or 16-gauge) peripheral IV lines should be placed.
How does hypothermia affect blood gases?
Decreased body temperature (hypothermia) causes a leftward shift in the oxyhemoglobin dissociation curve, i.e. increases hemoglobin affinity for oxygen, whereas increased body temperature (hyperthermia) causes a rightward shift, i.e. decreases hemoglobin affinity for oxygen [8].
Does hypothermia cause respiratory alkalosis?
Introduction: Mild therapeutic hypothermia improves outcomes in a number of clinical conditions, but can also alter metabolic function through changes that can influence acid-base balance, such as shifting the hemoglobin-oxygen dissociation curve to the left (contributing to metabolic acidosis), or decreasing metabolic …
What causes electrolyte disturbance in hypothermic patients?
In hypothermic patients, serum electrolyte disturbance occurs because of the increased renal excretion of electrolytes and the resulted intracellular shift. The reason for the increased renal excretion includes changes in volume adjustment in blood circulation, cardiac preload and also impaired tubular function.
What is the pathophysiology of hypothermia?
The hypothermia induced diuresis, along with tubular dysfunction and intracellular ion shifts, resulting in a decreased serum concentration of several electrolytes, including magnesium, potassium, and phosphate. Regular measurement and correction (if necessary) should be performed.
How does hypothermia affect the renal tubular cells?
Hypothermia presumably blocks many of the enzymatic activities of the renal tubular cell, so that the regulatory effect of the kidney upon acid-base homeostasis is completely lost.
What happens if hypothermia is left untreated?
Left untreated, this may cause hypovolemia, electrolyte disturbances, and hemoconcentration. The hypothermia induced diuresis, along with tubular dysfunction and intracellular ion shifts, resulting in a decreased serum concentration of several electrolytes, including magnesium, potassium, and phosphate.