[HSF] Persistant Hyperkalemia (OT)

[psimha]

Do you use Kilo Pascal for mm Hg ? 9They do in Belgium !!)
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 NSAID's , Aminoglycosides withdrawn.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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>
>