%0 Journal Article
%T About Usefulness of Kalemia Monitoring after Blunt Liver Trauma
%A Francesco Meriggi
%A Paolo Gramigna
%A Paola Tramelli
%J HPB Surgery
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/279708
%X Background. The aim of this study is to investigate the evidence of hypokalemia as a suitable parameter for therapeutic decision making after severe blunt liver trauma. Methods. We reviewed the medical records of 11 patients (9 M, 2 F, mean age 32 years) admitted to San Matteo Hospital of Pavia between 2007¨C2009. All of them were victims of road accidents hospitalized for blunt liver injury and submitted to surgery. Results. Hypokalemia was observed in 7/11 (63.6%) patients during the preoperative period (mean value 2.91£¿mEq/L). Serum potassium concentration normalized in all patients at the 7th postoperative day only ( ). Conclusions. According to literature results, our study confirms that after blunt hepatic injury serum potassium levels may decrease significantly. Therefore, kalemia must be carefully monitored in order to establish appropriate treatment and avoid any complications. 1. Introduction Trauma patients are shown to have a high incidence of admission hypokalemia, which predicts the seriousness of trauma itself. It is often associated to hyperglycemia and is subsequent to circulating epinephrine [1]. Serum potassium decrease is particularly frequent in young patients with blunt head trauma or spinal cord trauma and has a worsening prognostic implication in terms of morbidity and mortality [2]. Concerning blunt abdominal trauma, significant hypokalemia has been observed in patients with liver injury. On the contrary, no hypokalemia has been described in patients with other abdominal visceral injuries (e.g., spleen, mesentery) [3¨C5]. Besides elevation of serum aspartate and alanine aminotransferases (AST and ALT) [6, 7], there is evidence of a few-day-lasting hypokalemia [4, 5], despite the normal values of other serum electrolytes (Na+, Cl£¿), daily urinary potassium and blood acid-base balance. The aim of the present study is to investigate the evidence of hypokalemia as a suitable parameter for therapeutic decision making after severe blunt liver trauma. 2. Materials and Methods We reviewed a personal series of 11 patients (9£¿M, 2 F, mean age 32 years) admitted to San Matteo Hospital of Pavia between 2007¨C2009. All of them were victims of road accidents and hospitalized for blunt liver injury (III-V grade according to Moore organ injury scaling) [8] without any other abdominal visceral lesions associated (Table 1). Table 1: Clinical series of 11 patients with blunt liver injury submitted to surgery. D1, D3 and D7 are, respectively, the 1st, 3rd and 7th postoperative day. Within the first 12¨C24 hours from admission, they were all submitted
%U http://www.hindawi.com/journals/hpb/2012/279708/