[HSF] Persistant Hyperkalemia (OT)

[psimha]

Yes , we have a peculiar situation as we were using metric system prior 
to many other countries so when people shifted to SI we did not really 
shift totally as we were not using the FPS system. Thus for all old 
"traditional" estimations like glucose and creat we have the metric 
system. mmol is common to SI and Metric and so that overlap occurs !!
Prasanna
Ben Bidstrup wrote:
> 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 NSAID's , Aminoglycosides withdrawn.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
>>>>>
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