Distribution of potassium levels on admission for CPR--severe hypokalaemia with dysmorphophobic eating disorders.

Abstract

To evaluate the prevalence and cause of severe hypokalaemia in patients administered for cardiopulmonary resuscitation (CPR) for non-traumatic cardiac arrest. We conducted a retrospective database review in the setting of a University hospital on 281 consecutive adult patients admitted to emergency admission, cardiac catheterization laboratory or intensive care units for resuscitation from non-traumatic cardiac arrest. The first available potassium value was evaluated. The mean potassium level was 3.9 ± 0.9 mmol/l and thus within the reference range of 3.5-5.0 mmol/l, but the overall prevalence of hypokalaemia was high (31.0%). Moderate rather than severe hypokalaemia was typically observed, with 95% of patients exhibiting potassium levels above 2.7 mmol/l. Among those six patients with extreme hypokalaemia defined as a potassium levels below the 2.5 percentile, two adult females were identified to suffer from previously untreated body scheme disorder with furosemide abuse (potassium 1.1 and 1.4 mmol/l). Another patient (potassium 2.1 mmol/l) suffered from poorly controlled bulimia nervosa and acute diarrhoea due to GI infection and one (potassium 2.4 mmol/l) from untreated bulimic anorexia. In contrast to moderately reduced potassium which is a frequent finding in adult patients at the time of admission for non-traumatic cardiac arrest, severe hypokalaemia is uncommon. The high prevalence of patients with body dysmorphophobic eating disorders in this group underscores accidental self-induced hypokalaemia may evolve as an important differential diagnosis in cardiac arrest in young female patients.