[HSF] Persistant Hyperkalemia (OT)

[Ben Bidstrup]

Can I ask a peripheral question? (I am going to anyway) Why are you 
(or your labs) mixing SI units with conventional chemistry units?

>an obvious question - even though I know you are a very good doctor (and not
>just a great surgeon) - no compartment syndrome anywhere?  (arm from a-line,
>legs).  The lactate is also concerning?  I have seen this a few times, just
>kinda goes away and never really sure why.
>
>michael
>
>
>On 11/1/06, prasannasimha <prasannasimha at gmail.com> wrote:
>>
>>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NSAID's , Aminoglycosides withdrawn.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
>>>>
>>>>  _______________________________________________
>>>>  OpenHeart-L mailing list
>>>>
>>>>  Send postings to:
>>>>  OpenHeart-L at lists.hsforum.com
>>>>
>>>>  To UNSUBSCRIBE, to CHANGE email address, or to view archives:
>>>>  http://mmp.cjp.com/mailman/listinfo/openheart-l
>>>>
>>>>  All messages transmitted by the OpenHeart-L are subject to the policies
>>>>  and
>>>>  disclaimers posted at:
>>>>  http://www.hsforum.com/listdisclaim
>>>>  -----------------------------------------
>>>>
>>>  _______________________________________________
>>>  OpenHeart-L mailing list
>>>
>>>  Send postings to:
>>>  OpenHeart-L at lists.hsforum.com
>>>
>>>  To UNSUBSCRIBE, to CHANGE email address, or to view archives:
>>>  http://mmp.cjp.com/mailman/listinfo/openheart-l
>>>
>>>  All messages transmitted by the OpenHeart-L are subject to the
>>>  policies and disclaimers posted at:
>>>  http://www.hsforum.com/listdisclaim
>>>  -----------------------------------------
>>>
>>_______________________________________________
>>OpenHeart-L mailing list
>>
>>Send postings to:
>>OpenHeart-L at lists.hsforum.com
>>
>>To UNSUBSCRIBE, to CHANGE email address, or to view archives:
>>http://mmp.cjp.com/mailman/listinfo/openheart-l
>>
>>All messages transmitted by the OpenHeart-L are subject to the policies
>>and
>>disclaimers posted at:
>>http://www.hsforum.com/listdisclaim
>>-----------------------------------------
>>
>_______________________________________________
>OpenHeart-L mailing list
>
>Send postings to:
>OpenHeart-L at lists.hsforum.com
>
>To UNSUBSCRIBE, to CHANGE email address, or to view archives:
>http://mmp.cjp.com/mailman/listinfo/openheart-l
>
>All messages transmitted by the OpenHeart-L are subject to the 
>policies and disclaimers posted at:
>http://www.hsforum.com/listdisclaim
>-----------------------------------------


-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon