Universität zu Köln

Pasquier, M., Blancher, M., Buse, S., Boussat, B., Debaty, G., Kirsch, M., de Riedmatten, M., Schoettker, P., Annecke, T. and Bouzat, P. (2019). Intra-patient potassium variability after hypothermic cardiac arrest: a multicentre, prospective study. Scand. J. Trauma Resusc. Emerg. Med., 27 (1). LONDON: BMC. ISSN 1757-7241

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Abstract

Background To date, the decision to set up therapeutic extra-corporeal life support (ECLS) in hypothermia-related cardiac arrest is based on the potassium value only. However, no information is available about how the analysis should be performed. Our goal was to compare intra-individual variation in serum potassium values depending on the sampling site and analytical technique in hypothermia-related cardiac arrests. Methods Adult patients with suspected hypothermia-related refractory cardiac arrest, admitted to three hospitals with ECLS facilities were included. Blood samples were obtained from the femoral vein, a peripheral vein and the femoral artery. Serum potassium was analysed using blood gas (BGA) and clinical laboratory analysis (CL). Results Of the 15 consecutive patients included, 12 met the principal criteria, and 5 (33%) survived. The difference in average potassium values between sites or analytical method used was <= 1 mmol/L. The agreement between potassium values according to the three different sampling sites was poor. The ranges of the differences in potassium using BGA measurement were - 1.6 to + 1.7 mmol/L; - 1.18 to + 2.7 mmol/L and - 0.87 to + 2 mmol/L when comparing respectively central venous and peripheral venous, central venous and arterial, and peripheral venous and arterial potassium. Conclusions We found important and clinically relevant variability in potassium values between sampling sites. Clinical decisions should not rely on one biological indicator. However, according to our results, the site of lowest potassium, and therefore the preferred site for a single potassium sampling is central venous blood. The use of multivariable prediction tools may help to mitigate the risks inherent in the limits of potassium measurement.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pasquier, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Blancher, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buse, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boussat, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Debaty, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirsch, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED de Riedmatten, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoettker, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Annecke, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bouzat, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-124289
DOI:	10.1186/s13049-019-0694-3
Journal or Publication Title:	Scand. J. Trauma Resusc. Emerg. Med.
Volume:	27
Number:	1
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1757-7241
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EUROPEAN-RESUSCITATION-COUNCIL; SEVERE ACCIDENTAL HYPOTHERMIA; EXTRACORPOREAL LIFE-SUPPORT; SERUM POTASSIUM; AVALANCHE VICTIMS; GUIDELINES; PSEUDOHYPERKALEMIA; AGREEMENT; HEMOLYSIS; SURVIVAL Multiple languages Emergency Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12428