POTASSIUM AND THE CAUSE OF DEATH IN TRAUMATIC SHOCK

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Abstract
Conc. of K in serum consistently increases when secondary shock is induced by reestablishment of circulation in an ischemic limb. Death usually occurs with respiratory failure prior to or simultaneous with cardiac arrest, and is usually not due to K poisoning. Concs. of K in serum while both respiration and heart are active in the shocked animal seldom exceed 8mM/liter. These levels are too low to cause any circulatory embarrassment; minor electrocardio-graphic changes only are noted. Exceptionally, death may be due to cardiac arrest from spontaneous autointoxication with K. Long persistence of the shocked state with failure of renal excretion favor this event. It is characterized by the attainment of concs. of serum K exceeding 10 mM/liter while both heart and respiration are active, and by cardiac arrest while the respirations are still normally active. After respiratory arrest, there may be a rapid agonal elevation of the serum K. Such increases are the result and not the cause of the terminal event.