1EDITORIALS Hyperkalemia: The Potential for Harm Clive DM, Stoff JS. Hyperkalemia: the potential for harm.

No other electrolyte abnormality arouses as much concern and alarm in the intensive care unit (ICU) as hyperkalemia. Every clinician knows that an ele-vated level of potassium in the serum can have rap-idly lethal consequences. The maintenance of nor-mal resting potential in all electrically excitable cells is directly dependent upon the ratio of potas-sium concentration on both sides of the cell mem-brane. As the extracellular potassium concentra-tion increases, the &dquo;window of safety&dquo; between resting and threshold potential rapidly closes. The result is neuromuscular instability and cardiac arrthythmia. The clinician’s concern echoes that of nature, which has provided us with a remarkable series of fail-safe mechanisms to maintain th