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August 26, 1983

Hypokalemia After Resuscitation

Author Affiliations

Redding, Calif

JAMA. 1983;250(8):1025. doi:10.1001/jama.1983.03340080015007

To the Editor.—  Drs Thompson and Cobb (1982;248:2860) have carefully documented the presence of hypokalemia in patients hospitalized soon after myocardial infarction or resuscitation from ventricular fibrillation. They were not, however, able to describe a mechanism adequately explaining their observation.More than a decade ago, we described1 a small group of patients who were hypokalemic at the time of hospital admission for acute myocardial infarction, all of whom had recurrent ventricular fibrillation or tachycardia, none of whom had received out-of-hospital resuscitation, and most of whom had not been receiving diuretics and were without clinical reason to explain their potassium imbalance. Most of our patients were young men with striking diaphoresis and prominent clinical vasoconstriction, observations that suggested a massive adrenergic response.Epinephrine injection is followed by a brief rise in plasma potassium level caused by exit of potassium from liver cells. This rise is soon followed, however, by a