Abstract
A case is presented of hyperkalaemia (13.6 mEq · L−1) occurring during cardiopulmonary bypass using warm blood cardioplegia (K+ 40–60 mEq · L−1). Treatment with epinephrine, calcium chloride, sodium bicarbonate, and furosemide reduced K+ to 6.5 mEq · L−1 within 30 min and myocardial performance was enhanced with amrinone and cardiac rhythm was controlled with A-V segmental pacing. It is believed that the hyperkalaemia resulted from a combination of the surgical procedure (mitral valve replacement) and the use of warm cardioplegia. The purpose of this report is to increase the awareness of the possibility of hyperkalaemia with warm cardioplegia and to describe a successful therapeutic regimen.
Résumé
On présente un cas d’hyperkaliémie (13,6 mmol · L−1) survenant au cours d’une circulation extracorporelle sous cardioplégie sanguine chaude (K+ 40–60 mmol · L−1). On a initié un traitement à l’épinéphrine, au chlorure de calcium, au bicarbonate de sodium et au furosémide. La performance myodardique est augmentée par de l’amrinone et le rythme cardiaque contrôlé par entrainement segmentaire A-V. On émet l’opinion que l’hyperkaliémie fut déclenchée par l’association du type d’intervention (remplacement mitral) à la cardioplégie chaude. L’objectif de cette observation est de mettre en garde contre la possibilité d’hyperkaliémie associée à la cardioplégie chaude et de proposer une thérapeutique curative.
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Kao, Y.J., Mian, T., Kleinman, S. et al. Hyperkalaemia: a complication of warm heart surgery. Can J Anaesth 40, 67–70 (1993). https://doi.org/10.1007/BF03009322
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DOI: https://doi.org/10.1007/BF03009322