Author + information
- Received July 21, 1986
- Revision received October 28, 1986
- Accepted November 25, 1986
- Published online July 1, 1987.
- David M. Salerno, MD, PhD, FACC*,1,
- K. Joseph Elsperger, CCPT1,
- Peter Helseth, BS1,
- Maryann Murakami, BA1 and
- Vinaya Chepuri, BS1
- ↵*Address for reprints: David M. Salerno, MD, Division of Cardiology, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, Minnesota 55415.
Serum electrolytes were measured before and sequentially for 3 hours after resuscitation from ventricular fibrillation in a canine model that was designed to approximate the human cardiac arrest and resuscitation process. Twenty anesthetized dogs were resuscitated from ventricular fibrillation; 7 required epinephrine during resuscitation and 13 did not. To control for the effects of anesthesia, 10 dogs were anesthetized and instrumented, but ventricular fibrillation was not induced.
Serum potassium decreased from 3.7 ± 0.3 mmol/liter at baseline to 3.2 ± 0.4 mmol/liter 45 minutes after resuscitation in the experimental dogs resuscitated without epinephrine, as compared with 3.6 ± 0.3 to 3.4 ± 0.2 mmol/liter in control dogs (p = 0.07 versus control dogs by two-way analysis of variance) and returned toward baseline at the end of 3 hours. Serum calcium decreased from 9.6 ± 0.6 mg/dl at baseline to 8.9 ± 0.9 mg/dl at 5 minutes after resuscitation as compared with 9.4 ± 0.7 to 9.5 ± 0.7 mg/dl in control dogs (p < 0.05 versus control dogs) and returned to baseline by 3 hours. Serum magnesium decreased from 1.5 ± 0.1 to 1.3 ± 0.2 mEq/dl by 3 hours in resuscitated dogs as compared with 1.6 ± 0.2 to 1.5 ± 0.2 mEq/dl in control dogs (p = 0.06 versus control dogs). These changes in serum potassium, calcium and magnesium were independent of the administration of epinephrine during the resuscitation process. Changes in potassium were independent of arterial pH or bicarbonate therapy. Serum glucose increased after ventricular fibrillation but not in control dogs (p < 0.0005 versus control). No changes in other electrolytes were observed.
Thus, serum potassium, calcium and magnesium decreased after resuscitation from ventricular fibrillation in this canine model. These data suggest that, although the hypokalemia seen after ventricular fibrillation in humans may in some cases precede the event, a decrease in potassium may develop after resuscitation.
- Received July 21, 1986.
- Revision received October 28, 1986.
- Accepted November 25, 1986.
- American College of Cardiology Foundation