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학습 자료 둘러보기 →A serum potassium of 6.8 mEq/L is a critical, life-threatening emergency due to the imminent risk of cardiac arrest. In the context of Acute Kidney Injury (AKI), this creates a dangerous spiral known as BRASH syndrome (Bradycardia, Renal failure, AV nodal blockade, Shock, Hyperkalemia).
The priority is immediate cardiac stabilization. Hyperkalemia directly depresses cardiac conduction, potentiating AV nodal blockers and leading to profound bradycardia and shock. This hemodynamic collapse further reduces kidney perfusion, worsening the hyperkalemia in a vicious cycle.
Do not delay treatment to recheck the potassium level if an ECG shows changes like peaked T-waves or widened QRS. Administer intravenous calcium gluconate or calcium chloride immediately to stabilize the myocardium, followed by therapies to shift potassium intracellularly.
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