Potassium in red blood cell and myocardium in open heart surgery--in relation to postoperative arrhythmias
Otani, S.
Nihon Kyobu Geka Gakkai 28(6): 990-1001
1980
ISSN/ISBN: 0369-4739 PMID: 7410920 Document Number: 167824
Hypophosphatemia in open-heart surgical cases apparently is not directly related to postoperative arrhythmias. To investigate intra- and extracellular K balance during and after open-heart surgery, the K concentration in red blood cell [RBC] during and after the surgery was compared to the clinical features in 140 patients. In another 60 cases, myocardial K was measured and compared with RBC K. The RBC K was studied after glucose-insulin-K [GIK] administration. K concentration in RBC was measured by an indirect method and the normal range was 103.2 .+-. 8.8 meq/l. There was no interrelation between serum and RBC K. The RBC K was low in the cardiac group (95 meq/l), especially in cases associated with cardiac failure. Myocardial K (average 65 meq/kg) was low in acquired valvular disease and high in congenital disease. RBC K relates to myocardial K (r = 0.775), indicating that the measurement of RBC K will reflect the changes in myocardial K. Arrhythmias seen with low K in RBC disappeared after RBC K returned to normal. Apparently the measurement of RBC K is more reasonable than of serum K. By administration of GIK, the increase of K concentration in RBC was 2 times more than by administration of K alone. GIK is the treatment of choice for K depression arrhythmias.