Intra‐operative hyperkalaemia following extensive muscle dissection

Das, Sayan; Pandia, Mihir Prakash; Sharma, Manju

doi:10.1111/j.1365-2044.2008.05466.x

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…Other factors include medications that cause hyperkalemia (angiotensinconverting enzyme inhibitors, angiotensin II receptor blockers, aldosterone antagonists, potassium-sparing diuretics, potassium supplements, alpha-adrenergic agents, beta-blockers, nonsteroidal anti-inflammatory drugs, digoxin, trimethoprim, and heparin), red blood cell transfusion, liver surgery (transplant, lobectomy, prolonged ischemia, and reperfusion), major vascular surgery, organ/limb ischemia-reperfusion, extensive muscle dissection, tumor lysis syndrome, low cardiac output state, metabolic acidosis, hypothermia, hypocalcemia, hyperglycemia, low insulin levels, and so on. 1,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Mannitol as used for neurosurgery can cause severe hyperkalemia and cardiac arrest in otherwise healthy patients. Several cases have been reported in the literature usually presenting after 20-60 minutes of its administration and appear to be infusion rate related.…”

Section: Discussionmentioning

confidence: 99%

High-Dose Insulin for Hyperkalemic Cardiac Arrest

Shikhooun¹,

Abdulhadi

Yafes

et al. 2022

American Journal of Therapeutics

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Hyperkalemic cardiac arrest diagnosis can be elusive and management difficult as the cardiac rhythm restoration is often not achieved until the potassium level decreases to a relatively normal level for the patient who suffers the arrest. Current treatment modalities can take hours to achieve this goal. We describe two patients who survived a witnessed hyperkalemic cardiac arrest after being managed with conventional advanced cardiac life support and unconventionally high doses of intravenous insulin.

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Section: Discussionmentioning

confidence: 99%

High-Dose Insulin for Hyperkalemic Cardiac Arrest

Shikhooun¹,

Abdulhadi

Yafes

et al. 2022

American Journal of Therapeutics

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“…Hyperkalemia has been reported anecdotally related to muscle injury following dissection of the paraspinal muscles during spinal fusion [ 18 ]. Das et al reported hyperkalemia (serum potassium of 5.9 mEq/L) with ECG changes in a 10-year-old girl during laminoplasty from T4 to S1 [ 18 ]. The authors postulated that damage to the paraspinal muscles during surgical retraction led to muscle damage and release of potassium.…”

Section: Discussionmentioning

confidence: 99%

Etiology and Treatment of Intraoperative Hyperkalemia During Posterior Spinal Fusion in an Adolescent

et al. 2020

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Hyperkalemia, defined as a serum or plasma potassium greater than 5.5 mEq/L, while an uncommon occurrence in children, is a serious medical problem that warrants immediate attention as it can result in serious cardiac arrhythmias and death. Although hyperkalemia may occur in the critically ill patient or in the setting of renal failure and insufficiency, there are limited reports of its occurrence during intraoperative care. The authors report a previously healthy, 18-year-old patient, who developed hyperkalemia intraoperatively during posterior spinal fusion to treat adolescent idiopathic scoliosis. The potential etiologies of hyperkalemia are reviewed, a differential diagnosis for the possible etiologies presented, and treatment modalities discussed.

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“…[7] Fat necrosis due to excessive tissue handling may lead to hypocalcaemia due to binding of calcium to adipose tissues. Hypocalcemia has been associated with pancreatitis, gastrointestinal disorders and bowel surgeries.…”

Section: Discussionmentioning

confidence: 99%

Delayed recovery due to exaggerated acid, base and electrolyte imbalance in prolonged laparoscopic repair of diaphragmatic hernia

et al. 2011

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The acid, base and electrolyte changes are usually observed in the perioperative settings. We report a case of prolonged laparoscopic repair of left-sided diaphragmatic hernia which involved a lot of tissue handling and fluid replacement leading to acid, base and electrolyte imbalance. A 42-year-old male underwent prolonged laparoscopic repair under general anesthesia. Intraoperatively, surgeon reported that contents of hernia includes bowel along with mesentery, spleen and lot of fatty tissue The blood loss was about 2 L which was replaced with 1 L of colloid and 7.5 L of lactated ringer. Near the end of surgery arterial blood gas analysis revealed metabolic acidosis, hyperkalemia, and hypocalcemia leading to delayed recovery. We conclude prolonged laparoscopic surgery involving lot of tissue handling including gut and fat should be monitored for acid, base, electrolyte imbalance and corrected timely to have uneventful rapid recovery.

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Intra‐operative hyperkalaemia following extensive muscle dissection

Cited by 5 publications

References 3 publications

High-Dose Insulin for Hyperkalemic Cardiac Arrest

High-Dose Insulin for Hyperkalemic Cardiac Arrest

Etiology and Treatment of Intraoperative Hyperkalemia During Posterior Spinal Fusion in an Adolescent

Delayed recovery due to exaggerated acid, base and electrolyte imbalance in prolonged laparoscopic repair of diaphragmatic hernia

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