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| Clinical value of ECG among infants and children with hyperkalemia |
| WEN Jie, ZHENG Fei, WEI Xin,LI Hualian |
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Abstract Objective To explore the clinical value of electrocardiogram (ECG) in evaluating the influence of serum potassium concentration(SPC) on child patients cardiac conduction system and hemodynamics. MethodsE CG and other clinical data were selected from 48 cases of infants or children with hyperkalemia in our hospital; the relationship among the ECG manifestations, SPC, clinical symptoms and prognosis were observed. The enrolled child patients were divided into 4 groups—mild, moderate, severe and extremely severe group according to SPC; they were classified into group A-E in turn according to the degree of ECG abnormalities related to hyperkalemia from mild to severe. Those patients without hyperkalemia related ECG manifestation were set as control group. Results Positive correlation trend is shown between the abnormality degree of ECG changes and SPC. In the absence of sinoventricular conduction (group A, B and C), common ECG changes related to hyperkalemia are found in those cases with mild and moderate increase of SPC; there is no patient with severe increase of SPC or case of death. In the presence of sinoventricular conduction (group D and E), the patients with severe increase of SPC are the majority; they are mainly complicated by complex arrhythmia ECG changes while all of them are found hemodynamic changes; there are three cases of death among these patients. In the control group, SPC variation is not accompanied by hyperkalemia related ECG changes; no adverse outcome is found. Conclusion ECG changes can reflect the influence of SPC variation on the cardiac conduction system rapidly and accurately. For the patients with hyperkalemia, it is suggested to closely observe ECG changes to prevent hemodynamic abnormalities, and apply calcium channel blockers in time to reverse the influence of SPC changes so as to improve child patients’ prognosis. Clinicians should especially avoid the delay of treatment opportunities for judging the disease’s progress only from the increase of SPC.
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