Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest

Hans Kirkegaard; Anders M. Grejs; Simon Gudbjerg; Christophe Duez; Anni Jeppesen; Christian Hassager; Timo Laitio; Christian Storm; Fabio Silvio Taccone; Markus B. Skrifvars; Eldar Søreide

doi:10.1111/aas.14053

Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest

Hans Kirkegaard^*, Anders M. Grejs, Simon Gudbjerg, Christophe Duez, Anni Jeppesen, Christian Hassager, Timo Laitio, Christian Storm, Fabio Silvio Taccone, Markus B. Skrifvars, Eldar Søreide

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin - Center for Akutforskning

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

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Abstract

Background: Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM. Methods: This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements. Results: On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p <.05) during the first 24 h. Magnesium concentration stayed within the reference interval. Median ionized calcium concentration increased from 1.11 (IQR 1.1–1.2) mmol/l during the first 24 h (p <.05), whereas median phosphate concentration dropped to 1.02 (IQR 0.8–1.2) mmol/l (p <.05) and stayed low. During rewarming, potassium concentrations increased, and magnesium and ionizes calcium concentration decreased (p <.05). Median 24-h diuresis results on days one and two were 2198 and 2048 ml respectively, and the electrolyte excretion mostly stayed low in the reference interval. Conclusions: Electrolytes mostly remained within the reference interval. A temporal change occurred in potassium, magnesium and calcium concentrations with TTM’s different phases. No hypothermia effect on diuresis was detected, and urine excretion of electrolytes mostly stayed low.

Originalsprog	Engelsk
Tidsskrift	Acta Anaesthesiologica Scandinavica
Vol/bind	66
Nummer	5
Sider (fra-til)	615-624
Antal sider	10
ISSN	0001-5172
DOI	https://doi.org/10.1111/aas.14053
Status	Udgivet - maj 2022

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10.1111/aas.14053Licens: CC BY-NC-ND

Acta Anaesthesiol Scand - 2022 - Kirkegaard - Electrolyte profiles with induced hypothermia A sub study of a clinicalForlagets udgivne version, 1,32 MBLicens: CC BY-NC-ND

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Kirkegaard, H., Grejs, A. M., Gudbjerg, S., Duez, C., Jeppesen, A., Hassager, C., Laitio, T., Storm, C., Taccone, F. S., Skrifvars, M. B., & Søreide, E. (2022). Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest. Acta Anaesthesiologica Scandinavica, 66(5), 615-624. https://doi.org/10.1111/aas.14053

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title = "Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest",

abstract = "Background: Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM. Methods: This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements. Results: On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p <.05) during the first 24 h. Magnesium concentration stayed within the reference interval. Median ionized calcium concentration increased from 1.11 (IQR 1.1–1.2) mmol/l during the first 24 h (p <.05), whereas median phosphate concentration dropped to 1.02 (IQR 0.8–1.2) mmol/l (p <.05) and stayed low. During rewarming, potassium concentrations increased, and magnesium and ionizes calcium concentration decreased (p <.05). Median 24-h diuresis results on days one and two were 2198 and 2048 ml respectively, and the electrolyte excretion mostly stayed low in the reference interval. Conclusions: Electrolytes mostly remained within the reference interval. A temporal change occurred in potassium, magnesium and calcium concentrations with TTM{\textquoteright}s different phases. No hypothermia effect on diuresis was detected, and urine excretion of electrolytes mostly stayed low.",

keywords = "Calcium, Electrolytes, Humans, Hypothermia, Induced/methods, Hypothermia/therapy, Magnesium, Out-of-Hospital Cardiac Arrest/therapy, Phosphates, Potassium, Sodium",

author = "Hans Kirkegaard and Grejs, {Anders M.} and Simon Gudbjerg and Christophe Duez and Anni Jeppesen and Christian Hassager and Timo Laitio and Christian Storm and Taccone, {Fabio Silvio} and Skrifvars, {Markus B.} and Eldar S{\o}reide",

note = "{\textcopyright} 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.",

year = "2022",

month = may,

doi = "10.1111/aas.14053",

language = "English",

volume = "66",

pages = "615--624",

journal = "Acta Anaesthesiologica Scandinavica",

issn = "0001-5172",

publisher = "Blackwell Munksgaard",

number = "5",

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Kirkegaard, H , Grejs, AM, Gudbjerg, S, Duez, C , Jeppesen, A, Hassager, C, Laitio, T, Storm, C, Taccone, FS, Skrifvars, MB & Søreide, E 2022, 'Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest', Acta Anaesthesiologica Scandinavica, bind 66, nr. 5, s. 615-624. https://doi.org/10.1111/aas.14053

Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest. / Kirkegaard, Hans ; Grejs, Anders M.; Gudbjerg, Simon et al.
I: Acta Anaesthesiologica Scandinavica, Bind 66, Nr. 5, 05.2022, s. 615-624.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Electrolyte profiles with induced hypothermia

T2 - A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest

AU - Kirkegaard, Hans

AU - Grejs, Anders M.

AU - Gudbjerg, Simon

AU - Duez, Christophe

AU - Jeppesen, Anni

AU - Hassager, Christian

AU - Laitio, Timo

AU - Storm, Christian

AU - Taccone, Fabio Silvio

AU - Skrifvars, Markus B.

AU - Søreide, Eldar

PY - 2022/5

Y1 - 2022/5

N2 - Background: Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM. Methods: This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements. Results: On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p <.05) during the first 24 h. Magnesium concentration stayed within the reference interval. Median ionized calcium concentration increased from 1.11 (IQR 1.1–1.2) mmol/l during the first 24 h (p <.05), whereas median phosphate concentration dropped to 1.02 (IQR 0.8–1.2) mmol/l (p <.05) and stayed low. During rewarming, potassium concentrations increased, and magnesium and ionizes calcium concentration decreased (p <.05). Median 24-h diuresis results on days one and two were 2198 and 2048 ml respectively, and the electrolyte excretion mostly stayed low in the reference interval. Conclusions: Electrolytes mostly remained within the reference interval. A temporal change occurred in potassium, magnesium and calcium concentrations with TTM’s different phases. No hypothermia effect on diuresis was detected, and urine excretion of electrolytes mostly stayed low.

AB - Background: Electrolyte disturbances can result from targeted temperature treatment (TTM) in out-of-hospital cardiac arrest (OHCA) patients. This study explores electrolyte changes in blood and urine in OHCA patients treated with TTM. Methods: This is a sub-study of the TTH48 trial, with the inclusion of 310 unconscious OHCA patients treated with TTM at 33°C for 24 or 48 h. Over a three-day period, serum concentrations were obtained on sodium potassium, chloride, ionized calcium, magnesium and phosphate, as were results from a 24-h diuresis and urine electrolyte concentration and excretion. Changes over time were analysed with a mixed-model multivariate analysis of variance with repeated measurements. Results: On admission, mean ± SD sodium concentration was 138 ± 3.5 mmol/l, which increased slightly but significantly (p <.05) during the first 24 h. Magnesium concentration stayed within the reference interval. Median ionized calcium concentration increased from 1.11 (IQR 1.1–1.2) mmol/l during the first 24 h (p <.05), whereas median phosphate concentration dropped to 1.02 (IQR 0.8–1.2) mmol/l (p <.05) and stayed low. During rewarming, potassium concentrations increased, and magnesium and ionizes calcium concentration decreased (p <.05). Median 24-h diuresis results on days one and two were 2198 and 2048 ml respectively, and the electrolyte excretion mostly stayed low in the reference interval. Conclusions: Electrolytes mostly remained within the reference interval. A temporal change occurred in potassium, magnesium and calcium concentrations with TTM’s different phases. No hypothermia effect on diuresis was detected, and urine excretion of electrolytes mostly stayed low.

KW - Calcium

KW - Electrolytes

KW - Humans

KW - Hypothermia, Induced/methods

KW - Hypothermia/therapy

KW - Magnesium

KW - Out-of-Hospital Cardiac Arrest/therapy

KW - Phosphates

KW - Potassium

KW - Sodium

UR - http://www.scopus.com/inward/record.url?scp=85127240080&partnerID=8YFLogxK

U2 - 10.1111/aas.14053

DO - 10.1111/aas.14053

M3 - Journal article

C2 - 35218019

AN - SCOPUS:85127240080

SN - 0001-5172

VL - 66

SP - 615

EP - 624

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 5

ER -

Electrolyte profiles with induced hypothermia: A sub study of a clinical trial evaluating the duration of hypothermia after cardiac arrest

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