Risk factors for the development of hypokalemia in neonatal diarrheic calves

新生腹泻犊牛发生低钾血症的危险因素

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Abstract

BACKGROUND: Neonatal diarrheic calves have a clear negative potassium balance because of intestinal losses and decreased milk intake but in the presence of acidemia, they usually show normokalemic or hyperkalemic plasma concentrations. OBJECTIVES: To assess whether marked hypokalemia occurs in response to the correction of acidemia and dehydration and to identify factors that are associated with this condition. ANIMALS: Eighty-three calves with a clinical diagnosis of neonatal diarrhea. METHODS: Prospective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate, 0.9% saline and 40% dextrose infusion solutions. RESULTS: The proportion of hypokalemic calves after 24 hours of treatment (19.3%) was twice as great as it was on admission to the hospital. Plasma K(+) after 24 hours of treatment was not significantly correlated to venous blood pH values at the same time but positively correlated to venous blood pH values on admission (r = 0.51, P < .001). Base excess on admission (Odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.70-0.94), duration of diarrhea (OR = 1.37, 95% CI = 1.05-1.80), milk intake during hospitalization (OR = 0.54, 95% CI = 0.37-0.79) and plasma sodium concentrations after 24 hours (OR = 1.12, 95% CI = 1.01-1.25) were identified to be independently associated (P < .05) with a hypokalemic state after 24 hours of treatment. CONCLUSIONS AND CLINICAL IMPORTANCE: Findings of this study suggest that marked depletion of body potassium stores is evident in diarrheic calves that suffered from marked metabolic acidosis, have a low milk intake and a long history of diarrhea.

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