ELECTROCARDIOGRAPHIC CHANGES DURING HEMODIALYSIS, WITH OBSERVATIONS ON CONTRIBUTION OF ELECTROLYTE DISTURBANCES TO DIGITALIS TOXICITY

Abstract

Ecgs. were recorded at intervals during the course of 13 consecutive hemodialyses with a Kolff type "artificial kidney." The changes observed during dialyses were predictable from the changes in electrolyte concns. However in 4 digitalized patients there was an increase in digitalis effect evident in the ecg. In 2 cases this accompanied a simultaneous rise of serum Ca and reduction in serum K; in 2 cases there was only a rise in Ca and no change in K. Arhythmias supervened in 2 digitalized cases, one a supraventricular and one a ventricular tachycardia. It is concluded that a rise in serum Ca in some cases is equally as important as a fall in serum K in the production of digitalis intoxication.