This review article describes the pathophysiology and common aetiologies of hyperkalaemia including pseudohyperkalaemia, renal impairment, medication, rhabdomyolysis and aldosterone deficiency. Two clinical cases are used to describe symptoms (mainly muscle weakness and arrhythmias) and illustrate different management options. An approach to management including relevant investigations and inte...

Introduction Acute renal failure is a frequent complication in critically ill patients and carries a mortality of 50 to 70%.[1] The traditionally held belief has been that kidney failure does not kill on its own as long as complications such as hyperkalaemia, acidosis and volume overload are prevented. There is evidence to suggest that this may not always be the case. We know today that acute r...

Suxamethonium causes an efflux of potassium (K+) ions by depolarizing acetylcholine receptors within the neuromuscular junction and produces a transient, small rise in serum K+ concentration in normal individuals that is usually of little clinical importance. Despite the clear efficacy and relative safety of suxamethonium in many patients, anaesthetists are also very aware that acute, severe hy...

We describe four patients who developed symptomatic hypoglycaemia following treatment of hyperkalaemia with insulin and dextrose. Two patients had a delayed onset of hypoglycaemia, between 5 and 6 hours after treatment despite use of a 'soluble' type of insulin. A review of the literature revealed a variety of insulin and dextrose regimes but no research to assess the metabolic effects of such ...

OBJECTIVE To determine the influence of lactic acidosis, the Bohr effect, and exercise induced hyperkalaemia on the occurrence of the heart rate deflection point (HRDP) in elite (professional) cyclists. METHODS Sixteen professional male road cyclists (mean (SD) age 26 (1) years) performed a ramp test on a cycle ergometer (workload increases of 5 W/12 s, averaging 25 W/min). Heart rate (HR), g...

Rebound hyperkalaemia 4 hours after discontinuation of a glucose-insulin-potassium infusion inhibited an already compromised conduction system leading to ventricular standstill in a 41 year old man after re-do aortic valve surgery. Resuscitation was successful and allowed him to return from Australia to his home on Christmas Island. Glucose-insulin-potassium (GIK) infusions to reduce myocardial...

Dangerous hyperkalaemia has been reported following administration of succinyleholine chloride (SCC) to patients with burns, 1,2 massive trauma, a tetanus, 4 and a variety of neuromuscular disorders. T M Recently, Tammisto, e t al., 8 reported increases in blood levels of creatine phosphokinase (CPK) following administration of succinyleholine in patients with strabismus and found them to be hi...