[HSF] Persistant Hyperkalemia

[prasannasimha]

No not on Metformin (Not a diabetic) or any Aldosterone inhibitors, 
NSAID's , Aminoglycosides withdrawn. No known preop problem to cause 
hyperkalemia.

Prasanna

Michael Firstenberg wrote:
> 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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