[HSF] Persistant Hyperkalemia

[psimha]

Very appealing and I thought of it but should I risk it ??
Prasanna
Ben Bidstrup wrote:
> You could re-expose to heparin and see what happens.
>
>> Michael
>> Patient has stabilized. I was suggested by the CCML group to rule out 
>> type 4 renal tubular acidosis and while doing a bit of research on 
>> that I found out a list of Aldosterone antagonists included Heparin. 
>> I stopped Heparin in the flushes and the  K values came crashing down 
>> within 3 hours (we were struggling to get it down till then). Was it 
>> a coincidence - I do not know but it truly decreased in association 
>> (temporally) with stopping Heparin.
>> Prasanna
>> Michael Firstenberg wrote:
>>> now that you are 2 days into this -
>>> any better/worse?
>>> anything manifest itself?
>>>
>>> m
>>>
>>>
>>> On 11/2/06, Dr. Roberto Battellini <battr at medizin.uni-leipzig.de> 
>>> 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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