[HSF] Persistant Hyperkalemia

[Michael Firstenberg]

any pre-op medical problems?
Metformin pre-op?


michael


On 11/1/06, prasannasimha <prasannasimha at gmail.com> wrote:
>
> Double valve replacement with Tricuspid annuloplasty done 2 days back.
> Uneventful post op and extubated on 5 mics of dobutamine and dopamine.
> Started getting hyperkalemia since today 3 AM. No clinical or
> biochemical evidence of low output/hemolysis. Urine clear.Echo normal -
> no evidence of paravalvar leak . Lactate 2.7 mmol. Creat 1.5 mg/dL and
> BUN 43 mg/dL
> Initially manged hyperkalemia with Lasix , Calcium , glucose Insulin
> Alkalinizaation K binding resin etc but K went upto 6.8 so started
> PDtoday mrning. K+ dropped to 5.1 but now despite good extraction on PD
> , good urine etc last K+ just done now is 6.0. Cannot identify the cause
> of such persistant hyperkalemia. I have removed all nephrotoxic drugs.
> No additional K + sources and I have specifically asked K free diet.
> Any ideas/suggestions.
> Prasanna
>
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