Potassium Imbalance

钾失衡 Imbalance of potassium Zhao Gaofeng M.D.

1.hypopotassemia （低 钾） 2.hyperpotassemia （高 钾）

• Hypopotassemia （低钾血症） Concept: K in serum (concentration) <3.5mmol/L

Causes of hypopotassemia （病因） • Less intake of k （摄入少） • More transportation of k into cells

（进入细胞内） • More loss of k through gastrointestinal tract （进入消化道） • More loss of k through urinary tract （泌尿道丢失） • More loss of k through the skin

（皮肤丢失）

Manifestation （症状） • • • •

Myasthynia 肌无力，腱反射减弱，软瘫 Intestinal paralysis 腹胀，肠麻痹 Irregular heart beating 心律紊乱 ECG: U wave becomes higher and sharp OR emerges

Diagnostics • Case history • Symptoms and signs • Lab tests

TRENTMENTS • Treat the primary diseases • Supply k following the principles

RULES • Oral intake of k as possible as the patient can

• Supply

crystal or/and colloid solution— blood/volume---blood pressure-urine volume

• >30—40ml/hr

• 10%kcl <0.3% • 10%kcl < 80d/min • Monitor ECG and k

• Be patient

HYPERPOTASSEMIA 高钾血症 • Concept:k>5.5mmol/l

reasons •K supplied too much--- 输入过多 / 细胞内外移 • 排钾障碍 ARF

manifestation • Nonspecific: • Irregular HB(Arrthymia) 心律失 常，心脏骤停 • ECG: T wave-- higher and sharp--specific

Diagnosis •Case history--AFR •Manifestation—T wave

•Lab tests--k

treatments • Treat the primary diseases • Stop the intake of k

• Treat the arrhythmia （心律失常） ---(calcium)

Decrease k 1.transfer k into cells 5%NaHco3 100--200ML

OR 25%GS 100— 200ml+insulin 3—4g/ 1unit Insulin

2.Dialysis

（透析）

• Peritonaeum dialysis--腹膜透析　　 • Blood dialysis--血液透析

summary 1.hypo---2.hyper----