Why patients with severe trauma are prone to hyperkalemia

Caused by leukopenia.

With the development of society and the progress of society, people's life pressure is getting bigger and bigger, so they will have some minor illnesses and pains in life. And these minor illnesses and pains can pose a very serious threat to their lives, so today we are going to talk about hyperkalemia. There are many people who don't know what causes hyperkalemia and what it threatens if they get it.

What is hyperkalemiaThe first thing we need to understand is that potassium is the most abundant cation in our intracellular fluid, and it is mainly in a bound state. It is directly involved in some metabolic activities in the cell, and the right amount of potassium ion concentration and the ratio of the two sides in the cell membrane can produce some static electricity as well as some cell components. If their concentrations are too high, hyperkalemia is diagnosed, and hyperkalemia is also divided into acute and chronic.

If it is acute, it is necessary to rescue in time, otherwise it may cause our cardiac arrest.

Causing myocarditis, in fact, hyperkalemia is very harmful to the patient, and it is mainly manifested in the impact on the patient's heart, which may make the patient's heart in a very excited state. In this case, the patient lacks the influence on the automaticity of the heart and the contractility of the heart, which leads to some problems with the patient's heart. Either it causes myocarditis or the oliac muscle, then the impact on the patient's life in this case is very large.

Therefore, when you find that you have hyperkalemia, you must pay attention to it.

The contractility of the heart is reduced, followed by hyperkalemia, which also has a certain impact on the conductivity of the heart, because hyperkalemia can cause some conduction or blockage in our atria and ventricles. Well, this is mainly due to the rapid slowing down of myocardial excitement caused by hyperkalemia, resulting in a decrease in conductivity, if this situation is progressively more severe. It may inhibit the influx of calcium ions from our extracellular fluid, or even cause the excitation of our heart muscle cells and cause our heart to decrease its contractility, which can cause certain dangers to our lives.

If the concentration of potassium in the blood is higher, it is called hyperkalemia. The specific harm is mainly blood pressure and height, and the muscles have no strength, and the arrhythmia is arrhythmic.

It is that the concentration of potassium is exceeded, and it is very dangerous, and the harm will harm the kidneys, and the heart rate slows down, and the heart is paralyzed, and the muscles are weak, and they also like to sleep.

Hyperkalemia refers to a disease in which the blood potassium in the body is too high, and the most serious harm is that it can affect the health of the heart, and in severe cases, it can cause the heart to stop beating.

Hyperkalemia is a medical term that describes too much potassium in the blood. Hyperkalemia occurs if the kidneys are not functioning well, or if certain drugs are used, serum potassium is higher than normal. The most serious harm lies in the damage to the neuromuscular system and direct damage to the cardiovascular system.

It seriously damages the body's immunity and also increases the burden on the kidneys.

Harm: 1. Effect on cardiac excitability: Similar to the effect on skeletal muscle, in mild hyperkalemia, the ratio of k+i [k+e decreases, the intracellular k+ outflow decreases in the resting phase, and the negative value of resting potential decreases, so myocardial excitability increases.

Resting potential reduction** indicates that the cell membrane is in a state of partial depolarization, so the intramembrane potential rises slowly and by a small amplitude at phase 0 of the action potential.

This is because the fast sodium pores of the membrane are partially inactivated in the partially depolarized state, so the rapid influx of sodium at phase 0 is reduced. When serum potassium is markedly elevated, myocardial excitability decreases or even disappears because the resting potential is too small, because most or all of the tachysodium pores are inactivated and the heart beats can be stopped.

2. Effect on cardiac automaticity: In hyperkalemia, the potassium conductance on the membrane of the fast-response autonomic cell membrane of the atrial conduction tissue and the atrioventricular bundle-Purkinje fiber network increases, so after reaching the maximum repolarization potential, the intracellular potassium outflow is faster than normal and the sodium influx is relatively slow, so the automatic depolarization is slowed down and the automaticity is reduced.

3. Effect on cardiac contractility: As mentioned above, the increase in the concentration of K+ in extracellular fluid during hyperkalemia inhibits the influx of Ca2+ in myocardial repolarization phase 2, so the concentration of cardiomyocytes with internal Ca2+ decreases, the excitation-contraction coupling is weakened, and the contractility is reduced.

4. Effect on cardiac conductivity: As mentioned above, the rate of intramembranous potential rise in action potential phase 0 during hyperkalemia slows down and the amplitude decreases, so the diffusion of excitatory diffusion slows down and conductivity decreases, so conduction delay or block can occur in the atrium, atrioventricular or intraventricle. On ECG, there is a low, widening, or absent P-wave for atrial depolarization, a prolonged P-R interval for atrioventricular conduction, a decreased R-wave for ventricular depolarization, and a widening of the QR complex for intraventricular conduction.

Performance: 1Cardiovascular symptoms.

High potassium inhibits the myocardium and reduces myocardial tone, so there is bradycardia and cardiac enlargement, heart sounds are weakened, and arrhythmias are prone to occur, but heart failure does not occur. ECG is characteristic and correlates with the degree of potassium elevation. When serum potassium is greater than that, ECG shows a shortening of the Q-T interval.

The T wave is high and acute, and the base is narrow and tent-shaped; When serum potassium is 7 8 mmol, the amplitude of the P wave decreases, and the P-R interval is prolonged and the P wave disappears.

2.Neuromuscular symptoms.

In the early stage, there is often numbness in the limbs and around the mouth, extreme fatigue, muscle aches, and pale, clammy and cold limbs. When the blood potassium concentration reaches 7mmol L, the limbs are numb and paralyzed, first to the trunk and then to the limbs, and finally to affect the respiratory muscles, causing asphyxia. The central nervous system may be irritable or confused.

3.Other symptoms.

Because hyperkalemia causes increased acetylcholine release, it can cause nausea, vomiting, and abdominal pain. Due to the toxic effect of high potassium on muscles, quadriplegia and respiratory arrest can occur. All hyperkalemias have varying degrees of azotemia and metabolic acidosis.

The latter can worsen hyperkalemia.

Symptoms are often masked by the underlying condition. The main manifestations are extreme fatigue, muscle weakness, cold extremities, loss of tendon reflexes, and central nervous system symptoms such as sluggishness and drowsiness. Muffled heart sounds, slowed heart rate, premature ventricular contractions, atrioventricular block, ventricular fibrillation, or cardiac arrest.

The clinical symptoms of diagnosing hyperkalemia are not specific, and are often masked by the symptoms of the primary disease or uremia, so laboratory tests and electrocardiogram examinations are generally used as the main basis for diagnosis. Laboratory tests show a higher serum potassium concentration, often with metabolic acidosis, and decreased carbon dioxide binding. The electrocardiogram is an important indicator of diagnosis:

When the serum potassium is 6 mmol L, a polar narrow and high-pointed T wave appears; 7 At 9 mMoL L, the PR interval was prolonged, the P wave disappeared, the QRS complex widened, the R wave gradually decreased, the S wave deepened, and the ST segment fused with the T wave. At >9 10 mM L, a sine wave appeared, the QRS complex was extended, and the T wave was high. Then ventricular fibrillation and peristalsis.

Potassium ion we call life ions, this ion in the body in many tissues and organs have a very important impact, to maintain the normal physiological function of many muscle cells, potassium ion is low or high is not good, the normal concentration of blood potassium ion in our body is to millimole per liter such a concentration.

What are the hazards if the concentration is too high? The first hazard is the heart which is also the most important hazard, which may produce life-threatening conditions, high blood potassium concentration, hyperkalemia is harmful to the heart, mainly may lead to cardiac arrest.

In addition to the impact on the heart, hyperkalemia will have a corresponding impact on muscle cells and our bones on the gastrointestinal tract, so it is necessary to deal with hyperkalemia in a very urgent state, and it must not be delayed, otherwise it may cause patients to have very serious consequences.

Hyperkalemia can cause abnormalities in the body, and as the disease worsens, it can also affect the respiratory, central nervous system, and cardiovascular system, and in severe cases, it can be fatal.

It will be very harmful, because it is likely to lead to syncope, and it will also lead to a series of symptoms such as loss of appetite, nausea and vomiting, which will cause great damage to the body, and will also lead to a decrease in resistance and immunity.

One is muscle weakness, the second is muscle paralysis, the third is the reduction of myocardial contractility, the fourth is the impaired mobility, and the fifth is arrhythmia and cardiac arrest.

Once the potassium concentration is too high, the main effect is on the heart, which can cause heart rate slowing, atrioventricular block, and even ventricular fibrillation, and cardiac arrest. The nervous system is mainly manifested by sluggishness, drowsiness, and even coma.

Answer]: A1Captopril is an angiotensin-converting enzyme inhibitor that decreases A, inhibits aldosterone secretion, and increases serum potassium.

2.Low molecular weight heparin has a weak anticoagulant effect and a strong antithrombotic effect. It can cause bleeding, and can also cause thrombocytopenia, hypoaldosteronism with hyperkalemia, necrosis and other adverse reactions.

1. What is hyperkalemia

Potassium ions play a vital role in maintaining human cell metabolism, maintaining osmotic pressure inside and outside cells, maintaining cell membrane stress and cardiomyocyte function. 98% of potassium ions in the body are present in cells, and their metabolism is mainly excreted through urine. Hyperkalemia occurs when the balance between potassium intake and excretion in the body is disrupted, or when the distribution inside and outside the cells is abnormal, and the blood potassium concentration is exceeded.

Depending on the potassium level in the blood, hyperkalemia can be classified as mild (, moderate (, and severe ( . Hyperkalemia typically occurs in patients with chronic kidney disease and heart failure.

2. Causes of hyperkalemia

There are many causes of hyperkalemia, and in addition to deterioration of kidney function, the following factors can cause or worsen hyperkalemia:

1.mineral acidosis;

2.insulin insufficiency;

3.tissue damage (trauma, burns, rhabdomyolysis);

4.Decreased renal potassium excretion due to drug factors: including the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, potassium-sparing diuretics, calcineurin inhibitors, etc.;

5.Excessive dietary intake of potassium.

3. What are the symptoms of hyperkalemia?

There are many clinical manifestations of hyperkalemia, mainly affecting the cardiovascular system and neuromuscular function of the person

1.Neuromuscular symptoms: lead to weakened neuromuscular excitability, limb numbness, sluggishness, weakness, loss of tendon reflexes, etc., and in severe cases, swallowing, dyspnea, and even respiratory muscle paralysis and sudden death.

2.Cardiovascular system: It has an inhibitory effect on cardiomyocytes, causing symptoms such as slow heart rate, arrhythmias, and even sudden arrest.

4. How to tell if you have hyperkalemia

Hyperkalemia is diagnosed based on underlying disorders such as high potassium uptake, intracellular to extracellular transport of serum potassium, and decreased renal potassium excretion, combined with elevated serum potassium and electrocardiographic findings. On the one hand, pseudohyperkalemia should be ruled out, and on the other hand, the diagnosis of the primary disease should be emphasized.

Fifth, the first principle

1.Controlling the intake of potassium in diet and rehydration, reducing potassium should be active, controlling infection, and reducing cell breakdown.

2.Diuresis or oral cation exchange resin can promote potassium excretion, although hemodialysis can be performed in severe cases**.

3.Take care to protect the heart and use drugs to reduce the toxicity of potassium to the heart.

6. Dietary precautions

Reduce potassium intake and avoid foods high in potassium, such as vegetables (mushrooms, potatoes, winter vegetables, dried radish, kelp, seaweed), nuts (walnuts, almonds, hazelnuts), beans, fruits (bananas, oranges), soy sauce, monosodium glutamate, etc. It is best to soak vegetables in water before eating, studies have found that soaking vegetables for 4-5 hours can remove 50% of potassium. When eating meat, only meat is eaten and no broth is consumed.

Refuse to drink tea and coffee.

1] Liu Xu, Diao Zongli, Liu Wenhu. Research progress on serum potassium control in patients with chronic kidney disease[J].Journal of Clinical and Experimental Medicine, 2018, 17(01): 109-111

2] Clinical Diagnosis and Treatment Guidelines, Nephrology Register (2009).Edited by Chen Xiangmei.

It will bring great harm to the body, easily lead to muscle weakness, arrhythmia, easily lead to problems in various organs of the body, easily lead to physical discomfort, and easily lead to life and health threats.

Symptoms of hyperkalemia are mild muscle tremors, paresthesias in the hands and feet, weakness of the limbs, decreased or absent tendon reflexes, and even flaccid paralysis in severe cases. The biggest harm of hyperkalemia is the possibility of cardiac arrest. Hyperkalemia can cause metabolic acidosis.

Hyperkalemia carries a risk of cardiac arrest and should be treated aggressively**, starting with immediate discontinuation of all potassium-containing drugs or solutions. **Hyperkalemia, first of all, to counter the inhibitory effect of potassium ions on the heart, sodium lactate, sodium bicarbonate, and serum potassium can be transferred to cells. Dialysis can also be used to remove potassium so that the potassium in the blood can quickly drop to normal levels so as not to cause greater harm to the heart.