Absence of adverse outcomes in hyperkalemic patients undergoing vascular access surgery.
OBJECTIVE
The decision to cancel vascular access surgery because of hyperkalemia requires knowledge of the risks vs benefits. This study sought to identify and characterize cases where surgery had been performed in patients with uncorrected hyperkalemia.


METHODS
One thousand four hundred and seventy-two consecutive cases of vascular access surgery at an academic medical centre between 1995 and 2000 by a single surgeon were analyzed retrospectively.


RESULTS
Eight cases had clear documentation that the case proceeded with hyperkalemia. Anesthesia techniques were one general anesthetic, one regional block, five monitored anesthesia care (MAC), and one local infiltration only. Mean potassium was 6.9 mmol x L(-1) (range 6.1-8.0). In this series of selected asymptomatic hyperkalemic patients undergoing low risk surgery, no adverse results occurred.


CONCLUSIONS
While this review of eight cases (only one receiving general anesthesia) cannot be used to prove the safety of proceeding to surgery with uncorrected hyperkalemia, it does suggest that asymptomatic hyperkalemia may not be an absolute contraindication to vascular access surgery.
Olson
Ronald P
RP
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA. olson012@mc.duke.edu
Schow
Adam J
AJ
McCann
Richard
R
Lubarsky
David A
DA
Gan
Tong J
TJ
D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous; D002408:Catheters, Indwelling; D000075202:Contraindications; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures