Hyperkalemic cardiac arrest after cardiopulmonary bypass in a child with unsuspected duchenne muscular dystrophy.
Adverse reactions to volatile anesthetics and depolarizing muscle relaxants can occur in patients with Duchenne muscular dystrophy (DMD) resulting in acute rhabdomyolysis and hyperkalemia. We report a case of hyperkalemic cardiac arrest after cardiac surgery using cardiopulmonary bypass in a child with unsuspected DMD. Early diagnosis and management of hyperkalemia resulted in a successful outcome. Genetic testing confirmed the diagnosis of DMD. We recommend a thorough preoperative investigation, including creatine kinase estimation, in children with a history of unexplained motor delay.
Nathan
Aruna
A
*Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia; and †Department of Anesthesia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Ganesh
Arjunan
A
Godinez
Rodolfo I
RI
Nicolson
Susan C
SC
Greeley
William J
WJ
D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002675:Child, Preschool; D003402:Creatine Kinase / Q000097:blood; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D006947:Hyperkalemia / Q000209:etiology*; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications*
D003402:Creatine Kinase
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