Life-threatening reperfusion injury in skeletal muscle: a simple technique to control critical hyperkalemia.
A 55-year-old male suffering from acute abdominal aortic occlusion due to iatrogenic aortic dissection was urgently admitted to hospital. An axillo-bifemoral bypass was constructed 6 hours from the onset of dissection. Before and after revascularization, blood samples were repeatedly obtained from a systemic artery and femoral vein. The arterial potassium concentration gradually increased, reaching 7.3 mM/L. Oliguria and arrhythmias occurred, and the left lower limb became rigid 3 hours after reperfusion. The femoral artery and vein were clamped and within 30 minutes, the arterial potassium concentration fell to 4.8 mM/L. The urine output increased. The left lower limb was amputated, and the patient survived. Immediately following revascularization, hyperkalemia may occur. Clamping of the afferent and efferent vessels is recommended as a simple and practical technique to quickly control life-threatening hyperkalemia.
Utoh
J
J
First Department of Surgery, Kumamoto University School of Medicine, Kumamoto City, Japan.
Goto
H
H
Hirata
T
T
Hara
M
M
Moriyama
S
S
Ideta
I
I
Kitamura
N
N
D000671:Amputation, Surgical; D001012:Aorta, Abdominal / Q000601:surgery; D003250:Constriction; D003251:Constriction, Pathologic / Q000601:surgery; D005263:Femoral Artery; D005268:Femoral Vein; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000378:metabolism; D011188:Potassium / Q000097:blood; D015427:Reperfusion Injury / Q000097:blood / Q000150:complications* / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
D011188:Potassium