Tuesday October 03, 2006
Correction of hypokalemia in hypothermia

Hypothermia commonly causes hypokalemia but should be treated very cautiously and gently. As patient has been re-warmed, potassium exits cells and may cause deadly hyperkalemia. 1, 2 This is not a pseudo-hypokalemia but a phenomenon of electrolyte movement across cell membrane induced by whole body temperature change. There should be a written protocol for gentle correction and followup of potassium during hypothermia and hyperthermia phase.


Bonus Pearl: Pseudo-hypokalemia

Pseudo-hypokalemia is usually seen with very high WBC count, when the drawn sample is allowed to sit at room temperature for longer period of time. It happens due to uptake of plasma potassium by high leukocytes in the sample. If Pseudo-hypokalemia is suspected, real potassium level can be measured by sending specimen quickly (preferably taking manually to lab as soon as drawn) and requesting to measure potassium level in separated plasma or serum.



Related previous Pearl: The TransTubular Potassium Gradient - TTKG




References: click to get articles/abstracts

1. Hypothermia-induced hypokalemia Mil Med.1998 Oct;163(10):719-21.

2. Serum potassium levels during prolonged hypothermia, Intensive Care Medicine Volume 9, Number 5 / September, 1983, 275-277