Rational treatment of disturbances of the body potassium level is based on the physiology of water and electrolytes. Beginning with Ringer's studies of the effects of electrolytes on the heart, numerous investigations have indicated that the activity of all cells is altered by changes in the concentration of the potassium surrounding the cells. High plasma concentrations exert their most important effect on the heart, because arrhythmia and heart block are produced at plasma potassium concentrations of 8 to 10 mEq. per liter.1 A flaccid paralysis of skeletal muscle has been observed at high concentrations in some patients with advanced renal failure. The paralysis resembles that seen with low plasma potassium levels except that the electrocardiograms are characteristic of those of patients with potassium intoxication. The high-peaked T waves are the earliest electrocardiographic alterations, but absent P waves, spreading QRS complexes, and more advanced disturbances develop later.
When the potassium
Darrow DC. PHYSIOLOGICAL BASIS OF POTASSIUM THERAPY. JAMA. 1956;162(14):1310–1315. doi:10.1001/jama.1956.72970310003010
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