Hyperkalemia

Abstract

A comprehensive understanding of fluid and electrolyte balance is critical to managing severely ill surgical patients. Prior to treating such pathophysiology, one must understand normal physiologic control mechanisms. Potassium is the major intracellular cation and is critical to the function of nerve and muscle cells. Normal extracellular potassium levels range from 3.5 to 5 mEq/L. Hyperkalemia exists when levels are above 5.5 mEq/L, and it is a common clinical problem that is most often a result of impaired renal excretion secondary to acute or chronic renal insufficiency. When this occurs, it can result in palpitations, muscle pain, muscle weakness or numbness, and life-threatening dysrhythmias. The urgency of treatment is based on the presence of clinical manifestations, the cause of hyperkalemia, and the severity of the elevation of potassium.