HYPOTHERMIA-INDUCED HYPOKALEMIA

Hypothermia may be seen both as a presenting problem and as a part of therapeutic strategy. An illustrative case is presented. In our case o f severe head trauma, hypothermia was used as a therapeutic modality t o minimize the brain injury. While hypothermic, the patient developed severe hypokalemia and was supplemented with 400 mEq of potassium. Upo n rewarming, severe hyperkalemia occurred with resultant fatal arrhyth mias. Severe hypokalemia may be seen in hypothermic patients, which re presents a shift of potassium rather than a true loss. Careful managem ent of this electrolyte problem must be given to avoid hyperkalemia wi th rewarming.