Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest.
Journal
Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
revised:
20
01
2022
received:
14
11
2021
accepted:
16
02
2022
pubmed:
27
2
2022
medline:
27
4
2022
entrez:
26
2
2022
Statut:
ppublish
Résumé
Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM. This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements. On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p < .05) during the first 24 h. Magnesium concentration stayed within the reference interval. Median ionized calcium concentration increased from 1.11 (IQR 1.1-1.2) mmol/l during the first 24 h (p < .05), whereas median phosphate concentration dropped to 1.02 (IQR 0.8-1.2) mmol/l (p < .05) and stayed low. During rewarming, potassium concentrations increased, and magnesium and ionizes calcium concentration decreased (p < .05). Median 24-h diuresis results on days one and two were 2198 and 2048 ml respectively, and the electrolyte excretion mostly stayed low in the reference interval. Electrolytes mostly remained within the reference interval. A temporal change occurred in potassium, magnesium and calcium concentrations with TTM's different phases. No hypothermia effect on diuresis was detected, and urine excretion of electrolytes mostly stayed low.
Sections du résumé
BACKGROUND
Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM.
METHODS
This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements.
RESULTS
On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p < .05) during the first 24 h. Magnesium concentration stayed within the reference interval. Median ionized calcium concentration increased from 1.11 (IQR 1.1-1.2) mmol/l during the first 24 h (p < .05), whereas median phosphate concentration dropped to 1.02 (IQR 0.8-1.2) mmol/l (p < .05) and stayed low. During rewarming, potassium concentrations increased, and magnesium and ionizes calcium concentration decreased (p < .05). Median 24-h diuresis results on days one and two were 2198 and 2048 ml respectively, and the electrolyte excretion mostly stayed low in the reference interval.
CONCLUSIONS
Electrolytes mostly remained within the reference interval. A temporal change occurred in potassium, magnesium and calcium concentrations with TTM's different phases. No hypothermia effect on diuresis was detected, and urine excretion of electrolytes mostly stayed low.
Identifiants
pubmed: 35218019
doi: 10.1111/aas.14053
pmc: PMC9311071
doi:
Substances chimiques
Electrolytes
0
Phosphates
0
Sodium
9NEZ333N27
Magnesium
I38ZP9992A
Potassium
RWP5GA015D
Calcium
SY7Q814VUP
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
615-624Informations de copyright
© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.
Références
Am J Cardiol. 2017 Oct 1;120(7):1110-1113
pubmed: 28803654
Arctic Med Res. 1991;50 Suppl 6:23-7
pubmed: 1811574
Resuscitation. 2010 Dec;81(12):1642-7
pubmed: 20817376
Acta Anaesthesiol Scand. 2022 May;66(5):615-624
pubmed: 35218019
Aviat Space Environ Med. 2004 May;75(5):444-57
pubmed: 15152898
Anesthesiology. 2011 Apr;114(4):971-93
pubmed: 21364460
Crit Care Med. 2009 Jul;37(7 Suppl):S186-202
pubmed: 19535947
Ther Hypothermia Temp Manag. 2012 Mar;2(1):30-6
pubmed: 24717135
Biochem Biophys Res Commun. 2015 Apr 24;460(1):72-81
pubmed: 25998735
Resuscitation. 2010 Jan;81(1):117-22
pubmed: 19913975
Resuscitation. 2008 Dec;79(3):350-79
pubmed: 18963350
Am J Med. 1988 May;84(5):870-6
pubmed: 3364446
Ann Emerg Med. 1993 Feb;22(2 Pt 2):370-7
pubmed: 8434836
Best Pract Res Clin Anaesthesiol. 2015 Dec;29(4):471-84
pubmed: 26670818
Resuscitation. 1989;17 Suppl:S189-96; discussion S199-206
pubmed: 2551016
Resuscitation. 2003 Jan;56(1):9-13
pubmed: 12505732
Anesthesiology. 2019 Jul;131(1):186-208
pubmed: 31021845
Trials. 2016 May 04;17(1):228
pubmed: 27142588
Crit Care Med. 2001 Sep;29(9):1726-30
pubmed: 11546972
Ther Hypothermia Temp Manag. 2014 Dec;4(4):188-92
pubmed: 25247997
Ther Hypothermia Temp Manag. 2018 Mar;8(1):14-17
pubmed: 28665234
Medicine (Baltimore). 2000 Jan;79(1):1-8
pubmed: 10670405
J Neurosurg. 2001 May;94(5):697-705
pubmed: 11354399
Ther Hypothermia Temp Manag. 2020 Mar;10(1):76-81
pubmed: 31390319
Ther Hypothermia Temp Manag. 2013 Dec 1;3(4):173-177
pubmed: 24380030
Acta Physiol Scand. 1998 Apr;162(4):475-80
pubmed: 9597114
JAMA. 2017 Jul 25;318(4):341-350
pubmed: 28742911
J Emerg Med. 1985;3(2):105-16
pubmed: 3912426
Resuscitation. 2010 Dec;81(12):1632-6
pubmed: 20828913
Eur J Anaesthesiol. 2010 Apr;27(4):383-7
pubmed: 19858724