The Hemodynamic Effects of Potassium Infusion in Dogs

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Abstract
The hemodynamic effects of K infusion were studied in 8 normal and 5 reserpine-treated dogs, anesthetized with nitrous oxide-oxygen and paralyzed with succinyldicholine. Infusion rates of K were chosen to equal or exceed those obtained with rapid, massive transfusions of banked blood. Arterial blood K levels were correlated with changes in hemodynamic parameters. Normal animals were more resistant to deleterious changes in cardiac output, total peripheral resistance, mean transit time, heart rate, mean arterial pressure, stroke volume, and left ventricular work, although the difference was statistically significant only with the first three parameters. Reserpine treated animals survived much higher serum K concentrations than did normals. All normal dogs died in ventricular fibrillation, all reser-pinized dogs in asystole. Release of catecholamines seems at first to protect against the deleterious circulatory effects of moderate elevations of K; then, in combination with K, to hasten death when K increases further. The adverse effects in normal dogs were apparent usually only at K concentrations greater than those seen in clinical transfusions. The possibility of interaction of hyperkalemia with other events occurring during massive transfusions is discussed.