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Resuscitation from transfusion-associated hyperkalaemic ventricular fibrillation
Evidence to guide resuscitation from transfusion-related hyperkalaemic ventricular fibrillation is sparse. This case report describes a 29 kg patient undergoing scoliosis surgery who developed hyperkalaemic ventricular tachycardia/fibrillation following the replacement of over two blood volumes with...
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| Published in: | Anaesthesia and intensive care 2007-02, Vol.35 (1), p.110-113 |
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| container_title | Anaesthesia and intensive care |
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| creator | Woodforth, I J |
| description | Evidence to guide resuscitation from transfusion-related hyperkalaemic ventricular fibrillation is sparse. This case report describes a 29 kg patient undergoing scoliosis surgery who developed hyperkalaemic ventricular tachycardia/fibrillation following the replacement of over two blood volumes with banked blood in 90 minutes. Rapid reversion to sinus rhythm followed administration of 1.4 mmol of calcium chloride and two units of insulin (Actrapid, Novo Nordisk). The relevant literature is reviewed, indicating that an elevated serum ionised calcium level protects against hyperkalaemia, by an intracellular mechanism. Evidence supports the use of lignocaine, but not amiodarone, as additional treatment. |
| doi_str_mv | 10.1177/0310057X0703500117 |
| format | article |
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This case report describes a 29 kg patient undergoing scoliosis surgery who developed hyperkalaemic ventricular tachycardia/fibrillation following the replacement of over two blood volumes with banked blood in 90 minutes. Rapid reversion to sinus rhythm followed administration of 1.4 mmol of calcium chloride and two units of insulin (Actrapid, Novo Nordisk). The relevant literature is reviewed, indicating that an elevated serum ionised calcium level protects against hyperkalaemia, by an intracellular mechanism. Evidence supports the use of lignocaine, but not amiodarone, as additional treatment.</description><identifier>ISSN: 0310-057X</identifier><identifier>EISSN: 1448-0271</identifier><identifier>DOI: 10.1177/0310057X0703500117</identifier><identifier>PMID: 17323677</identifier><language>eng</language><publisher>United States: Sage Publications Ltd. (UK)</publisher><subject>Adolescent ; Calcium chloride ; Calcium Chloride - administration & dosage ; Care and treatment ; Case studies ; Dosage and administration ; Drug Therapy, Combination ; Equipment Failure ; Humans ; Hyperkalemia ; Hyperkalemia - drug therapy ; Hyperkalemia - etiology ; Hypoglycemic Agents - administration & dosage ; Insulin ; Insulin - administration & dosage ; Intraoperative Complications - etiology ; Intraoperative Complications - therapy ; Lidocaine ; Male ; Methods ; Orthopedic surgery ; Prevention ; Resuscitation - methods ; Risk factors ; Scoliosis ; Scoliosis - surgery ; Transfusion Reaction ; Ventricular fibrillation ; Ventricular Fibrillation - etiology ; Ventricular Fibrillation - therapy</subject><ispartof>Anaesthesia and intensive care, 2007-02, Vol.35 (1), p.110-113</ispartof><rights>COPYRIGHT 2007 Sage Publications Ltd. (UK)</rights><rights>Copyright Australian Society of Anaesthetists Feb 2007</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-5be5569f0582df932f229568b29e1012a2ca1b85e5602a0febe6d5670a6bd293</citedby><cites>FETCH-LOGICAL-c439t-5be5569f0582df932f229568b29e1012a2ca1b85e5602a0febe6d5670a6bd293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17323677$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Woodforth, I J</creatorcontrib><title>Resuscitation from transfusion-associated hyperkalaemic ventricular fibrillation</title><title>Anaesthesia and intensive care</title><addtitle>Anaesth Intensive Care</addtitle><description>Evidence to guide resuscitation from transfusion-related hyperkalaemic ventricular fibrillation is sparse. This case report describes a 29 kg patient undergoing scoliosis surgery who developed hyperkalaemic ventricular tachycardia/fibrillation following the replacement of over two blood volumes with banked blood in 90 minutes. Rapid reversion to sinus rhythm followed administration of 1.4 mmol of calcium chloride and two units of insulin (Actrapid, Novo Nordisk). The relevant literature is reviewed, indicating that an elevated serum ionised calcium level protects against hyperkalaemia, by an intracellular mechanism. Evidence supports the use of lignocaine, but not amiodarone, as additional treatment.</description><subject>Adolescent</subject><subject>Calcium chloride</subject><subject>Calcium Chloride - administration & dosage</subject><subject>Care and treatment</subject><subject>Case studies</subject><subject>Dosage and administration</subject><subject>Drug Therapy, Combination</subject><subject>Equipment Failure</subject><subject>Humans</subject><subject>Hyperkalemia</subject><subject>Hyperkalemia - drug therapy</subject><subject>Hyperkalemia - etiology</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Insulin</subject><subject>Insulin - administration & dosage</subject><subject>Intraoperative Complications - etiology</subject><subject>Intraoperative Complications - therapy</subject><subject>Lidocaine</subject><subject>Male</subject><subject>Methods</subject><subject>Orthopedic surgery</subject><subject>Prevention</subject><subject>Resuscitation - methods</subject><subject>Risk factors</subject><subject>Scoliosis</subject><subject>Scoliosis - surgery</subject><subject>Transfusion Reaction</subject><subject>Ventricular fibrillation</subject><subject>Ventricular Fibrillation - etiology</subject><subject>Ventricular Fibrillation - therapy</subject><issn>0310-057X</issn><issn>1448-0271</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><recordid>eNptkUtr3TAUhEVISG4efyCLYlLIzql0ZEn2MoTmAYGEkkV3QpaPGqW2dSvZgfz7yL0XStqihWD4ZhjOEHLK6AVjSn2hnFEq1HeqKBeUZm2HrFhV1SUFxXbJagHKhTgghym9ZKQBJfbJAVMcuFRqRR6_YZqT9ZOZfBgLF8NQTNGMyc0pC6VJKVhvJuyK57c1xp-mNzh4W7ziOEVv597Ewvk2-r7_HXFM9pzpE55s_yPydP316eq2vH-4ubu6vC9txZupFC0KIRtHRQ2dazg4gEbIuoUGGWVgwBrW1gKFpGCowxZlJ6SiRrYdNPyInG9i1zH8mjFNevDJYi4xYpiTVhQYiEpk8Owv8CXMcczVNEBVV1wCz9DnDfTD9Kj96EK-gV0S9SWra9VIJWSmLv5D5dctFwkjOp_1DwbYGGwMKUV0eh39YOKbZlQvE-p_J8ymT9vCcztg98ey3Yy_A4qXlaw</recordid><startdate>20070201</startdate><enddate>20070201</enddate><creator>Woodforth, I J</creator><general>Sage Publications Ltd. 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administration & dosage</topic><topic>Care and treatment</topic><topic>Case studies</topic><topic>Dosage and administration</topic><topic>Drug Therapy, Combination</topic><topic>Equipment Failure</topic><topic>Humans</topic><topic>Hyperkalemia</topic><topic>Hyperkalemia - drug therapy</topic><topic>Hyperkalemia - etiology</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Insulin</topic><topic>Insulin - administration & dosage</topic><topic>Intraoperative Complications - etiology</topic><topic>Intraoperative Complications - therapy</topic><topic>Lidocaine</topic><topic>Male</topic><topic>Methods</topic><topic>Orthopedic surgery</topic><topic>Prevention</topic><topic>Resuscitation - methods</topic><topic>Risk factors</topic><topic>Scoliosis</topic><topic>Scoliosis - surgery</topic><topic>Transfusion Reaction</topic><topic>Ventricular fibrillation</topic><topic>Ventricular Fibrillation - etiology</topic><topic>Ventricular Fibrillation - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Woodforth, I J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Australia & New Zealand Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Science Journals</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - 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This case report describes a 29 kg patient undergoing scoliosis surgery who developed hyperkalaemic ventricular tachycardia/fibrillation following the replacement of over two blood volumes with banked blood in 90 minutes. Rapid reversion to sinus rhythm followed administration of 1.4 mmol of calcium chloride and two units of insulin (Actrapid, Novo Nordisk). The relevant literature is reviewed, indicating that an elevated serum ionised calcium level protects against hyperkalaemia, by an intracellular mechanism. Evidence supports the use of lignocaine, but not amiodarone, as additional treatment.</abstract><cop>United States</cop><pub>Sage Publications Ltd. (UK)</pub><pmid>17323677</pmid><doi>10.1177/0310057X0703500117</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Anaesthesia and intensive care, 2007-02, Vol.35 (1), p.110-113 |
| issn | 0310-057X 1448-0271 |
| language | eng |
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| source | Alma/SFX Local Collection; SAGE |
| subjects | Adolescent Calcium chloride Calcium Chloride - administration & dosage Care and treatment Case studies Dosage and administration Drug Therapy, Combination Equipment Failure Humans Hyperkalemia Hyperkalemia - drug therapy Hyperkalemia - etiology Hypoglycemic Agents - administration & dosage Insulin Insulin - administration & dosage Intraoperative Complications - etiology Intraoperative Complications - therapy Lidocaine Male Methods Orthopedic surgery Prevention Resuscitation - methods Risk factors Scoliosis Scoliosis - surgery Transfusion Reaction Ventricular fibrillation Ventricular Fibrillation - etiology Ventricular Fibrillation - therapy |
| title | Resuscitation from transfusion-associated hyperkalaemic ventricular fibrillation |
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