Potassium concentrations and ventricular ectopy: a prospective, observational study in post-cardiac surgery patients.

Abstract:

OBJECTIVE:To determine whether a correlation exists between concentrations of intracellular and extracellular potassium and to determine the frequency of ventricular ectopy in patients after cardiac operations. DESIGN:Prospective, observational clinical evaluation. SETTING:Surgical-respiratory intensive care unit of a university-affiliated tertiary care center. PATIENTS:Continuous 24-hr electrocardiographic monitoring was performed, and serum (extracellular) and erythrocyte (intracellular) potassium concentrations ([K+]e and [K+]i) were determined, before cardiopulmonary bypass, immediately postoperatively, and at 2, 4, 12, and 20 hrs after elective coronary bypass grafting in 31 patients. INTERVENTIONS:None. Potassium replacement was left to the discretion of the attending physicians. MEASUREMENTS AND MAIN RESULTS:Although the mean [K+]e varied significantly during the postoperative 24-hr period (p<.0001), the [K+]i did not (p = .953). No significant correlations were found between premature ventricular beats and [K+]i, [K+]e, or [K+]i/[K+]e (all p>.05). However, among the few patients who had one or more episodes of ventricular tachycardia (VT) within 30 mins of a study K+ sample, the mean [K+]e was significantly lower during the episode(s) of VT compared with the mean [K+]e in the absence of VT (p<.01). CONCLUSIONS:Although it is clear that over the clinically acceptable range of [K+]e and [K+]i concentrations seen in this population, there is no correlation between potassium concentrations and the occurrence of premature ventricular beats, the infrequent association of more serious ventricular ectopy, VT, with lower [K+]e concentrations supports the practice of using serum potassium to guide potassium replacement in patients after cardiac operations.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Johnson RG,Shafique T,Sirois C,Weintraub RM,Comunale ME

doi

10.1097/00003246-199911000-00018

subject

Has Abstract

pub_date

1999-11-01 00:00:00

pages

2430-4

issue

11

eissn

0090-3493

issn

1530-0293

journal_volume

27

pub_type

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