{"id":9682,"date":"2019-08-08T04:46:18","date_gmt":"2019-08-08T02:46:18","guid":{"rendered":"http:\/\/news-papers.eu\/?p=9682"},"modified":"2019-08-07T22:34:13","modified_gmt":"2019-08-07T20:34:13","slug":"9682-2","status":"publish","type":"post","link":"http:\/\/news-papers.eu\/?p=9682","title":{"rendered":"Hyperkali\u00e4mie: In aller K\u00fcrze"},"content":{"rendered":"<p style=\"text-align: justify;\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"3305\" data-permalink=\"http:\/\/news-papers.eu\/?attachment_id=3305\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/12\/Bildschirmfoto-2016-12-20-um-21.23.12-e1482265501906.png?fit=500%2C156\" data-orig-size=\"500,156\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"bildschirmfoto-2016-12-20-um-21-23-12\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/12\/Bildschirmfoto-2016-12-20-um-21.23.12-e1482265501906.png?fit=1024%2C320\" class=\"size-medium wp-image-3305 alignright\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/12\/Bildschirmfoto-2016-12-20-um-21.23.12.png?resize=300%2C94\" alt=\"\" width=\"300\" height=\"94\" \/>Die Hyperkali\u00e4mie ist eine h\u00e4ufige Elektrolytst\u00f6rungen, derer man in der pr\u00e4hospitalen Notfallmedizin (unbemerkt) und in der Notaufnahme regelhaft begegnen. Wir haben uns diesem Thema auf <a href=\"http:\/\/www.news-papers.eu\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>news-papers.eu<\/strong><\/a> schon einige Male angenommen. Eine interessante \u00dcbersicht hierzu bietet:<\/p>\n<blockquote><p><strong>Kettritz R.\u00a0Hyperkali\u00e4mie \u2013 Ursachen, Diagnostik und Therapie.\u00a0Dtsch Med Wochenschr 2019; 144: 180\u2013184.\u00a0DOI https:\/\/doi.org\/10.1055\/a-0641-9552<\/strong><\/p><\/blockquote>\n<p><strong>Eine Kurzzusammenfassung:\u00a0<\/strong><\/p>\n<p><strong>Definition &amp; Diagnostik<\/strong><\/p>\n<ul>\n<li>Hyperkali\u00e4mie ab Serumkalium &gt;5,1 mmol\/l.<\/li>\n<li>Echtheit der Hyperkali\u00e4mie pr\u00fcfen:\n<ul>\n<li>Blutabnahme suboptimal<\/li>\n<li>zu lange Stauung<\/li>\n<li>Exvivo-H\u00e4molyse<\/li>\n<li>ggf. arterielle Kontrolle der Blutgasanalyse<\/li>\n<\/ul>\n<\/li>\n<li>Transtubul\u00e4ren Kaliumgradienten:\u00a0(TTKG) = (U\/P Kalium)\/(U\/P Osmolarit\u00e4t) (Sollte &gt;5-&gt;10 sei; grobe Einsch\u00e4tzung\u00a0der Funktion des Sammelrohrs unter Ber\u00fccksichtigung\u00a0physiologischer Konzepte)<\/li>\n<li>Kalium-Kreatinin-Ratio = Kalium\/Kreatinin (mmol\/mmol); Wert&lt;1 spricht f\u00fcr eine inad\u00e4quat\u00a0niedrige renale Kaliumelimination bei Hyperkali\u00e4mie<\/li>\n<li><a href=\"http:\/\/news-papers.eu\/ekg-quiz-blickdiagnose-2\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>EKG-Hyperkali\u00e4mie-Diagnostik<\/strong><\/a>: verl\u00e4ngerte\u00a0PQ-Zeit, flache P-Wellen, spitze T-Wellen, QRS-Verbreiterung\u00a0und sinuswellenf\u00f6rmige Deformierung, Bradykardie<\/li>\n<\/ul>\n<p><strong>Therapeutische Ma\u00dfnahmen:\u00a0<\/strong><\/p>\n<ol>\n<li>Reduktion der Kaliumzufuhr<\/li>\n<li>Stabilisierung von Zellmembranen:\u00a0Insbesondere bei Hyperkali\u00e4mie-typischen EKG-Ver\u00e4nderungen oder L\u00e4hmungen &#8211;&gt; Zellmembranen \u201estabilisieren\u201c:\u00a0Kalzium-Glukonat (unter EKG Monitoring), nach 5 min wiederholen, Ccave: nicht bei Digitalis-Intoxikation<\/li>\n<li>Verschiebung von Kalium in den Intrazellul\u00e4rraum:\n<ul>\n<li>effektivste Methode ist die Insulingabe, Wirkungseintritt ist innerhalb von 60 Minuten, Glukose soll parallel geben werden um Hypoglyk\u00e4mien vorzubeugen; h\u00e4ufige Blutzuckerkontrollen notwendig<\/li>\n<li>Beta-Agonisten (z. B. Albuterol vernebelt oder Terbutalin sc), cave: nicht bei Patienten mit hohem kardiovaskul\u00e4rem Risiko<\/li>\n<li>Bikarbonat<\/li>\n<\/ul>\n<\/li>\n<li>Dialyse<\/li>\n<li>alle Medikamente, die die Kaliumausscheidung verhindern, sind zu reduzieren oder abzusetzen<\/li>\n<li>Hemmung der gastrointestinalen Kaliumaufnahme und F\u00f6rderung der Elimination: \u00a0Kaliumaustauschern als Natriumsalz (SPS, Resonium) oder als Kalziumsalz (CPS-Pulver) \u00a0wegen der obstipierenden Wirkung oft mit Sorbitol. (SPS selten\u00a0Kolonnekrosen,\u00a0hohe Mortalit\u00e4t)<\/li>\n<\/ol>\n<p>Lesen Sie auch auf <a href=\"http:\/\/www.news-papers.eu\" target=\"_blank\" rel=\"noopener noreferrer\">news-papers.eu\u00a0<\/a>zum Thema Hyperkali\u00e4mie:<\/p>\n<blockquote class=\"wp-embedded-content\" data-secret=\"PaQZU93o8f\"><p><a href=\"http:\/\/news-papers.eu\/5153-2\">Hyperkali\u00e4mie: Was tun?<\/a><\/p><\/blockquote>\n<p><iframe loading=\"lazy\" class=\"wp-embedded-content\" sandbox=\"allow-scripts\" security=\"restricted\" style=\"position: absolute; clip: rect(1px, 1px, 1px, 1px);\" src=\"http:\/\/news-papers.eu\/5153-2\/embed#?secret=PaQZU93o8f\" data-secret=\"PaQZU93o8f\" width=\"600\" height=\"338\" title=\"&#8222;Hyperkali\u00e4mie: Was tun?&#8220; &#8212; News Papers\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\"><\/iframe><\/p>\n<blockquote class=\"wp-embedded-content\" data-secret=\"kLM9MwbEr3\"><p><a href=\"http:\/\/news-papers.eu\/3338-2\">Kalium-Elektrolytst\u00f6rung: Teil 3: Hyperkali\u00e4mie<\/a><\/p><\/blockquote>\n<p><iframe loading=\"lazy\" class=\"wp-embedded-content\" sandbox=\"allow-scripts\" security=\"restricted\" style=\"position: absolute; clip: rect(1px, 1px, 1px, 1px);\" src=\"http:\/\/news-papers.eu\/3338-2\/embed#?secret=kLM9MwbEr3\" data-secret=\"kLM9MwbEr3\" width=\"600\" height=\"338\" title=\"&#8222;Kalium-Elektrolytst\u00f6rung: Teil 3: Hyperkali\u00e4mie&#8220; &#8212; News Papers\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\"><\/iframe><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Die Hyperkali\u00e4mie ist eine h\u00e4ufige Elektrolytst\u00f6rungen, derer man in der pr\u00e4hospitalen Notfallmedizin (unbemerkt) und in der Notaufnahme regelhaft begegnen. Wir haben uns diesem Thema auf news-papers.eu schon einige Male angenommen. [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":3305,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"__cvm_playback_settings":[],"__cvm_video_id":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false},"categories":[143],"tags":[144],"class_list":["post-9682","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-elektrolytstoerung","tag-hyperkaliaemie"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/12\/Bildschirmfoto-2016-12-20-um-21.23.12-e1482265501906.png?fit=500%2C156","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-2wa","jetpack-related-posts":[{"id":2973,"url":"http:\/\/news-papers.eu\/?p=2973","url_meta":{"origin":9682,"position":0},"title":"Aufl\u00f6sung &#8211; EKG-Quiz: Blickdiagnose","author":"Michael Bernhard","date":"Dezember 7, 2016","format":false,"excerpt":"Hier die Aufl\u00f6sung zum \"EKG-Quiz: Blickdiagnose\" vom 27.11.2016. Die meisten Leser haben es sogleich erkannt: Die Diagnose lautet: Hyperkali\u00e4mie (und alter Vorderwandinfarkt bei Zn NSTEMI bei bekannter 2 -Gef\u00e4\u00df-KKH und residueller LAD-Stenose). Erkennbar ist die Hyperkali\u00e4mie an dem sog. \"Kirchturm-T\", einer deutlich \u00fcberh\u00f6hten und spitzen T-Welle. Informationen zur Therapie und\u2026","rel":"","context":"In &quot;EKG-Quiz&quot;","block_context":{"text":"EKG-Quiz","link":"http:\/\/news-papers.eu\/?cat=118"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/11\/EKG1a-e1479929460621.jpg?fit=500%2C375&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":3338,"url":"http:\/\/news-papers.eu\/?p=3338","url_meta":{"origin":9682,"position":1},"title":"Kalium-Elektrolytst\u00f6rung: Teil 3: Hyperkali\u00e4mie","author":"Michael Bernhard","date":"M\u00e4rz 25, 2017","format":false,"excerpt":"Auch in diesem Post beziehen wir uns auf\u00a0diesen Weiterbildungsartikel: Ashurt J, et al.\u00a0Evidence-Based Management Of Potassium Disorders In The Emergency Department. EMP 2016; 18:11 Eine\u00a0Hyperkali\u00e4mie ist definiert ab einem Kaliunwert von <5,5 mmol\/l im Blut. Hierbei wird ein Bereich von 5,5-6,4 mmol\/l als mild, 6,5-7,5 mmol\/l als moderat\u00a0und >7,5 mmol\/l\u2026","rel":"","context":"In &quot;Elektrolytst\u00f6rung&quot;","block_context":{"text":"Elektrolytst\u00f6rung","link":"http:\/\/news-papers.eu\/?cat=143"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/12\/Bildschirmfoto-2016-12-21-um-08.47.26-e1482306487671.png?fit=500%2C288&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":5153,"url":"http:\/\/news-papers.eu\/?p=5153","url_meta":{"origin":9682,"position":2},"title":"Hyperkali\u00e4mie: Was tun?","author":"Michael Bernhard","date":"Juni 30, 2017","format":false,"excerpt":"Ein Gastbeitrag von Dr. Ulf Harding, Wolfsburg: St\u00f6rungen des Kaliumhaushaltes waren in der Vergangenheit schon Thema auf news-papers.eu: Die Hyperkali\u00e4mie Die Hypokali\u00e4mie Fallbericht zu Ursachen der Hyperkali\u00e4mie EKG-Quiz mit Hyperkali\u00e4mie In einer aktuellen Arbeit, die in \u201eDer An\u00e4sthesist\u201c erschienen ist, geben P. Groene und G. Hoffmann vom Klinikum der Universit\u00e4t\u2026","rel":"","context":"In &quot;Elektrolytst\u00f6rung&quot;","block_context":{"text":"Elektrolytst\u00f6rung","link":"http:\/\/news-papers.eu\/?cat=143"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/03\/Bildschirmfoto-2016-03-13-um-04.29.18-300x113.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":10677,"url":"http:\/\/news-papers.eu\/?p=10677","url_meta":{"origin":9682,"position":3},"title":"Was ist denn das BRASH-Syndrom?","author":"Michael Bernhard","date":"Dezember 28, 2019","format":false,"excerpt":"Steffen Graustoff und Lars Holtz gehen in einem aktuellem und sehr gut geschriebenen Artikel in Notfall&Rettungsmedizin auf das Thema\u00a0Hyperkali\u00e4mie und das sog. BRASH-Syndrom ein. Was ist das BRASH-Syndrom eigentlich ? Grauton S, et al. Hyperkali\u00e4mie und BRASH- Syndrom in der Notfallmedizin.\u00a0Klinische Relevanz und Zusammenhang mit EKG-Befunden. Notfall Rettungsmed 2019; LINK\u2026","rel":"","context":"In &quot;Elektrolytst\u00f6rung&quot;","block_context":{"text":"Elektrolytst\u00f6rung","link":"http:\/\/news-papers.eu\/?cat=143"},"img":{"alt_text":"Banane","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/12\/bananas-698608_1920.jpg?fit=1200%2C800&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/12\/bananas-698608_1920.jpg?fit=1200%2C800&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/12\/bananas-698608_1920.jpg?fit=1200%2C800&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/12\/bananas-698608_1920.jpg?fit=1200%2C800&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/12\/bananas-698608_1920.jpg?fit=1200%2C800&resize=1050%2C600 3x"},"classes":[]},{"id":14054,"url":"http:\/\/news-papers.eu\/?p=14054","url_meta":{"origin":9682,"position":4},"title":"NERDFacts zur Hyperkali\u00e4mie by NERDFallmedizin.de","author":"Michael Bernhard","date":"August 11, 2021","format":false,"excerpt":"Heute geht's in den NERDFacts zum Thema Hyperkali\u00e4mie. Echt wichtig und viel zu h\u00e4ufig \u00fcbersehen.\u00a0PDF des Beitrages: HObjPy-nerdfacts_hyperk\u00a0Herzlichen Dank\u00a0f\u00fcr die weiteren Details: https:\/\/nerdfallmedizin.blog\/2021\/08\/02\/nerdfacts-8-2021-hyperkaliamie\/","rel":"","context":"In &quot;Elektrolytst\u00f6rung&quot;","block_context":{"text":"Elektrolytst\u00f6rung","link":"http:\/\/news-papers.eu\/?cat=143"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/08\/Bildschirmfoto-2021-08-02-um-21.35.30.png?fit=1200%2C659&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/08\/Bildschirmfoto-2021-08-02-um-21.35.30.png?fit=1200%2C659&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/08\/Bildschirmfoto-2021-08-02-um-21.35.30.png?fit=1200%2C659&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/08\/Bildschirmfoto-2021-08-02-um-21.35.30.png?fit=1200%2C659&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/08\/Bildschirmfoto-2021-08-02-um-21.35.30.png?fit=1200%2C659&resize=1050%2C600 3x"},"classes":[]},{"id":16436,"url":"http:\/\/news-papers.eu\/?p=16436","url_meta":{"origin":9682,"position":5},"title":"Die Hyperkali\u00e4mie &#8211; Alle Jahre wieder &#8230;","author":"Michael Bernhard","date":"Dezember 30, 2022","format":false,"excerpt":"Hyperkali\u00e4mie ab Serumkaliumkonzentration von 5,5 mmol\/l lebensbedrohlich Infografik und Basisc bei NERDfallmedizin.de Weitere Informationen: http:\/\/news-papers.eu\/?p=9682 http:\/\/news-papers.eu\/?p=5153 http:\/\/news-papers.eu\/?p=3338 Ursachen: Freisetzung von Kalium aus der Zelle Beeintr\u00e4chtigung der renalen Ausscheidung, dies kann \u00fcber die Messung der Kaliumkonzentration im Urin verifiziert werden Kalium im Urin >30 mmol\/l: transzellul\u00e4re Verschiebung Kalium im Urin <30\u2026","rel":"","context":"In &quot;Elektrolytst\u00f6rung&quot;","block_context":{"text":"Elektrolytst\u00f6rung","link":"http:\/\/news-papers.eu\/?cat=143"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2022\/12\/Bildschirm%C2%ADfoto-2022-12-26-um-10.49.32-300x94.png?resize=350%2C200","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9682","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9682"}],"version-history":[{"count":8,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9682\/revisions"}],"predecessor-version":[{"id":10003,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9682\/revisions\/10003"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/3305"}],"wp:attachment":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9682"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9682"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9682"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}