Investigating the relationship between intra-operative electrolyte abnormalities (sodium and potassium) with post-operative complications of coronary artery bypass surgery


Department of Anesthesia, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Generally, the electrolyte abnormalities are seen in many hospitalized patients, and this problem increases in ones with heart diseases. The purpose of this study is determination of the prevalence of electrolyte abnormalities during the coronary artery bypass surgery (CABG) and detecting the relationship between these abnormalities with the complications after the surgeries.
Materials and Methods: This is a cross-sectional study, which is done in Chamran hospital, the medical and educational center of Isfahan, Iran, in 2011. The target population included the patients who have undergone CABG in this hospital. In this study, 100 patients who had been candidates for CABG were selected, and we extracted their recorded intra-operative electrolyte information. The collected data was entered into the computer and analyzed by SPSS software. The Chi-square and t student tests were used for data analysis.
Results: The mean ± SD of sodium during CABG was 137.95 ± 4.6 (range 127-152) mg\dl. Also, the mean ± SD of potassium was 4.65 ± 0.9 (range: 2.9-7.4). According to these results, 48 patients (48% of all) had electrolyte imbalance and 52 patients (52% of all) were normal. Sodium level in 71% of patients was normal, and in 29% of them was abnormal. Potassium level in 73% of individuals was normal, and in 27% of them was abnormal.
Conclusion: Giving an attention to electrolyte abnormalities in patients who have undergone CABG surgery is a considerable necessity for them, and sufficient arrangements are needed to prevent such abnormalities.


1. Crop MJ, Hoorn EJ, Lindemans J, Zietse R. Hypokalaemia and subsequent hyperkalaemia in hospitalized patients. Nephrol Dial Transplant 2007;22:3471-7.  Back to cited text no. 1
2. Clausen T. Role of Na+, K+-pumps and transmembrane Na+, K+-distribution in muscle function. The FEPS lecture - Bratislava 2007. Acta Physiol (Oxf) 2008;192:339-49.  Back to cited text no. 2
3. Kjeldsen K. Hypokalemia and sudden cardiac death. Exp Clin Cardiol 2010;15:e96-9.  Back to cited text no. 3
4. Hoes AW, Grobbee DE, Peet TM. Do non-potassium-sparing diuretics increase the risk of sudden cardiac death in hypertensive patients? Recent evidence. Drugs 1994;47:711-33.  Back to cited text no. 4
5. Braden GL, von Oeyen PT, Germain MJ, Watson DJ, Haag BL. Ritodrine and terbutaline-induced hypokalemia in preterm labor: Mechanisms and consequences. Kidney Int 1997;51:1867-75.  Back to cited text no. 5
6. Ho KM. Intravenous magnesium for cardiac arrhythmias: Jack of all trades. Magnes Res 2008;21:65-8.  Back to cited text no. 6
7. Stühlinger HG, Kiss K, Smetana R. Significance of magnesium in cardiac arrhythmias. Wien Med Wochenschr 2000;150:330-4.  Back to cited text no. 7
8. Beþoðul Y, Tünerir B, Ozdemir C, Aslan R. Magnesium-flush infusion into the aortic root just before reperfusion reduces the requirement for internal defibrillation and early post-perfusion arrhythmias. J Int Med Res 2003;31:202-9.  Back to cited text no. 8
9. Abernathy MH, Walmsley TA, Fowler RT. Further evidence for the importance of inter-sample air compression as a source of error in a continuous-flow (Technicon SMAC) system. Clin Chem 1982;28:1991-2.  Back to cited text no. 9
10. Rasmussen HS, Thomsen PE. The electrophysiological effects of intravenous magnesium on human sinus node, atrioventricular node, atrium, and ventricle. Clin Cardiol 1989;12:85-90.  Back to cited text no. 10
11. Humphreys M. Potassium disturbances and associated electrocardiogram changes. Emerg Nurse 2007;15:28-34.  Back to cited text no. 11
12. Smith RC, Leung JM, Keith FM, Merrick S, Mangano DT. Ventricular dysrhythmias in patients undergoing coronary artery bypass graft surgery: Incidence, characteristics, and prognostic importance. Study of Perioperative Ischemia (SPI) Research Group. Am Heart J 1992;123:73-81.  Back to cited text no. 12
13. Angelini P, Feldman MI, Lufschanowski R, Leachman RD. Cardiac arrhythmias during and after heart surgery: Diagnosis and management. Prog Cardiovasc Dis 1974;16:469-95.  Back to cited text no. 13
14. Treggiari-Venzi MM, Waeber JL, Perneger TV, Suter PM, Adamec R, Romand JA. Intravenous amiodarone or magnesium sulfate is not cost-beneficial prophylaxis for atrial fibrillation after coronary artery bypass surgery. Br J Anaesth 2000;85:690-5.  Back to cited text no. 14
15. Scoreki K, Ausiello D. Dimbalances of sodium and water homeostasis. In; Goldman L, Ausiello D, editors. Cecil medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007. Chap. 117.  Back to cited text no. 15
16. Aiyagari V, Deibert E, Diringer MN. FCCM. Hypernatremia in the neurologic intensive care unit. J Crit Care 2006;21:163-72.  Back to cited text no. 16