Hyperkalaemia
Clinical signs
- Decreased muscle tonus
- ECG:
- Peaked T-waves
- Broad QRS-complex
- Arrhythmias, asystole
Pathogenesis
- Haemolysed sample
- Increased Intake
High intake of potassium; oral (e.g. supplements/ diet) or iv
Post packet red cell transfusion (cell lysis)
- Extra-cellular shift of potassium
Cell lysis (e.g. chemotherapy, rhabdomyolysis)
Acidosis
Toxins (e.g. digitalis)
- Decreased excretion
Renal
- Oliguria
- Obstruction of ureter/urethra
- K+ saving diuretics
- Disruption of non-renal regulation
- Diabetes mellitus
- Adrenal insufficiency
- Medication
Treatment, based on 3 principles
- Facilitate K+- excretion
Calcium Resonium
Diuretics
Dialysis
- Stabilisation of myocardial membrane
Calcium gluconate
Increase shift ECV ->ICV
NaBic
- Promote intracellular shift of potassium
Insulin + dextrose