Postresuscitation electrolyte changes

Publisher Website
Google Scholar
Abstract
Hypokalemia frequently occurs after resuscitation from ventricular fibrillation (VF) in man. To test the causal roles of VF and resuscitation variables in this electrolyte change, we studied six groups of dogs: VF with CPR and electrical cardioversion (n = 9), control dogs with no intervention (n = 9), CPR without arrhythmia (n = 5), electrical cardioversion without arrhythmia (n = 5), CPR and cardioversion without arrhythmia (n = 5), and rapid right ventricular pacing (n = 5) (pacing rate 374 ± 68 beat/min; BP 79/52 mm Hg during pacing). Blood for K, Ca, Mg, and glucose analysis was collected before each intervention (or at baseline in control animals) and sequentially for 3 hr. Mg had a maximum change of 03 mEq/L in the VF group 7 min after resuscitation, but did not change in the other groups (p < .005). Glucose had a maximum change of 79 mg/dl in the VF group 7 min after resuscitation but did not change in the other groups (p < .005). Ca had a maximum decrease of 0.4 mg/dl in the VF group 15 min after resuscitation but did not decrease in the other groups (p < .005). K had a maximum decrease of 0.8 mEq/L in the VF group 60 min after resuscitation, whereas decreases were less in the other groups (p < .005). Thus, VF caused a rapid rise in Mg and glucose followed by a fall in Ca and K. These changes were independent of resuscitation efforts as well as the moderate hypotension induced by rapid right ventricular pacing. This implicates the severe hypotension associated with VF as the primary trigger for postresuscitation electrolyte changes.