Hypokalemia and Electrocardiographic Abnormalities During Acute Alcohol Withdrawal

THE SYNDROMES of acute alcohol withdrawal have been well defined, 1 but despite a large number of patients, relatively little is known of the metabolic changes accompanying withdrawal. Abnormalities in electrolyte metabolism during this acute phase have been reported, 2-4 but few prospective studies have been carried out. However, it has been reported that no significant alteration occurs in the serum electrolytes of normal volunteers during recovery from ingestion of large quantities of alcohol 5,6 ; in addition, no abnormalities were observed in a small series of chronic alcoholic patients. 7 During observation and evaluation of chronic alcoholic patients undergoing withdrawal at San Francisco General Hospital it was noted that the levels of serum potassium were frequently low and that cardiac arrhythmias and alterations in the ST segment, T, and U waves in the electrocardiograms were common. Consequently, a study was undertaken to determine the frequency and severity of hypokalemia