Universität zu Köln

Buse, Sarah, Blancher, Marc, Viglino, Damien, Pasquier, Mathieu, Maignan, Maxime ORCID: 0000-0002-4301-4213, Bouzat, Pierre ORCID: 0000-0003-4667-6738, Annecke, Thorsten ORCID: 0000-0002-2496-4432 and Debaty, Guillaume ORCID: 0000-0003-2879-0326 (2017). The impact of hypothermia on serum potassium concentration: A systematic review. Resuscitation, 118. S. 35 - 43. CLARE: ELSEVIER IRELAND LTD. ISSN 1873-1570

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Abstract

Background: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories. Methods: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. The search strategy included studies related to hypothermia and potassium levels. The relevant literature on clinical studies and experimental studies was reviewed by the authors. Results: Among the 50 studies included in the review, 39 (78%) reported a decrease in blood potassium levels upon hypothermia onset. Hypothermic hypokalaemia is linked to an intracellular shift rather than an actual net loss. The intracellular shift is caused by a variety of factors such as enhanced functioning of Na + K + ATPase, beta-adrenergic stimulation, pH and membrane stabilisation in deep hypothermia. In contrast, hypothermia can act as an aggravating factor in severe trauma with hyperkalaemia being an indicator of an irreversible state of cell death. An increase in the blood potassium level during hypothermia may result from a lack of enzyme functioning at cold temperatures and blocked active transport. Conclusion: Hypothermia causes an initial decrease of potassium levels; however, the final stage of hypothermic cardiac arrest can induce hyperkalaemia due to cell lysis and final depolarisation. Better understanding the physiopathology of potassium levels during accidental hypothermia could be critically important to better select patients who could benefit from aggressive resuscitation therapy such as extracorporeal cardiopulmonary resuscitation. (C) 2017 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Buse, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Blancher, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Viglino, Damien UNSPECIFIED UNSPECIFIED UNSPECIFIED Pasquier, Mathieu UNSPECIFIED UNSPECIFIED UNSPECIFIED Maignan, Maxime UNSPECIFIED orcid.org/0000-0002-4301-4213 UNSPECIFIED Bouzat, Pierre UNSPECIFIED orcid.org/0000-0003-4667-6738 UNSPECIFIED Annecke, Thorsten UNSPECIFIED orcid.org/0000-0002-2496-4432 UNSPECIFIED Debaty, Guillaume UNSPECIFIED orcid.org/0000-0003-2879-0326 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-220506
DOI:	10.1016/j.resuscitation.2017.07.003
Journal or Publication Title:	Resuscitation
Volume:	118
Page Range:	S. 35 - 43
Date:	2017
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1873-1570
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SEVERE ACCIDENTAL HYPOTHERMIA; CARDIAC-ARREST; EXTRACELLULAR POTASSIUM; THERAPEUTIC HYPOTHERMIA; CIRCULATORY ARREST; HEMORRHAGIC-SHOCK; ION ACTIVITY; RESUSCITATION; TEMPERATURE; HYPOXIA Multiple languages Critical Care Medicine; Emergency Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22050