Background. Sustained return of spontaneous circulation (ROSC) can be initially established in patients with out-of-hospital cardiac arrest (OHCA); however, the early postresuscitation hemodynamics can still be impaired by high levels of serum potassium (hyperkalemia). The impact of different potassium levels on early postresuscitation heart function has remained unclear. We aim to analyze the relationship between different levels of serum potassium and postresuscitation heart function during the early postresuscitation period (the first hour after achieving sustained ROSC). Methods. Information on 479 nontraumatic OHCA patients with sustained ROSC was retrospectively obtained. Measures of early postresuscitation heart function (rate, blood pressure, and rhythm), hemodynamics (urine output and blood pH), and the duration of survival were analyzed in the case of different serum potassium levels (low: <3.5; normal: 3.5–5; high: >5 mmol/L). Results. Most patients (59.9%, n = 287) had previously presented with high levels of potassium. Bradycardia, nonsinus rhythm, urine output <1 ml/kg/hr, and acidosis (pH < 7.35) were more common in patients with high levels of potassium (all ). Compared with hyperkalemia, a normal potassium level was more likely to be associated with a normal heart rate (OR: 2.97, 95% CI: 1.74–5.08) and sinus rhythm (OR: 2.28, 95% CI: 1.45–3.58). A low level of potassium was more likely to be associated with tachycardia (OR: 3.54, 95% CI: 1.32–9.51), urine output >1 ml/kg/hr (OR: 5.35, 95% CI: 2.58–11.10), and nonacidosis (blood pH >7.35, OR: 7.74, 95% CI: 3.78–15.58). The duration of survival was shorter in patients with hyperkalemia than that in patients whose potassium levels were low or normal (). Conclusion. Early postresuscitation heart function and hemodynamics were associated with the serum potassium level. A high potassium level was more likely to be associated with bradycardia, nonsinus rhythm, urine output <1 ml/kg/hr, and acidosis. More importantly, a high potassium level decreased the duration of survival.

中文翻译：

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不同血清钾水平对非创伤性院外心脏骤停患者复苏后心脏功能和血流动力学的影响。

背景。院外心脏骤停（OHCA）患者可初步建立持续自主循环恢复（ROSC）；然而，高水平的血清钾（高钾血症）仍会损害早期复苏后的血流动力学。不同钾水平对复苏后早期心脏功能的影响仍不清楚。我们旨在分析复苏后早期（达到持续 ROSC 后的第一个小时）不同水平的血清钾与复苏后心脏功能之间的关系。方法. 回顾性获得了 479 名具有持续 ROSC 的非创伤性 OHCA 患者的信息。在不同血清钾水平（低：<3.5；正常：3.5– 5；高：>5 mmol/L)。结果。大多数患者（59.9%，n = 287）以前曾出现过高钾水平。心动过缓、非窦性心律、尿量 <1 ml/kg/hr 和酸中毒（pH < 7.35）在高钾患者中更常见（所有）。与高钾血症相比，正常钾水平更可能与正常心率（OR：2.97，95% CI：1.74-5.08）和窦性心律（OR：2.28，95% CI：1.45-3.58）相关。低钾水平更可能与心动过速相关（OR：3.54，95% CI：1.32-9.51），尿量>1 ml/kg/hr（OR：5.35，95% CI：2.58-11.10），和非酸中毒（血液 pH >7.35，OR：7.74，95% CI：3.78–15.58）。高钾血症患者的生存期短于钾水平低或正常的患者（）。结论. 复苏后早期心脏功能和血流动力学与血清钾水平相关。高钾水平更可能与心动过缓、非窦性心律、尿量 <1 ml/kg/hr 和酸中毒有关。更重要的是，高钾水平会降低存活时间。