AW: [HSF] Persistant Hyperkalemia

[psimha]

Normal,
Prasanna
Dr. Roberto Battellini wrote:
> How high are CPK and CPKMB?
> Roberto
>
> -----Ursprüngliche Nachricht-----
> Von: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von prasannasimha
> Gesendet: Mittwoch, 1. November 2006 16:11
> An: ccm; OpenHeart-L at lists.hsforum.com
> Betreff: [HSF] Persistant Hyperkalemia
>
> 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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