Hypoglycemia and cardiac arrest in a critically ill patient on strict glycemic control.
Glycemic control in critically ill patients has become a subject of considerable interest since the publication of studies showing reduced morbidity and mortality in patients when blood glucose was maintained within a relatively low and narrow range (4.4 to 6.1 mM/L). We describe a patient who developed cardiac asystole while being given a concentrated glucose solution to treat severe hypoglycemia after administration of insulin. The mechanism in this patient appears to be hyperkalemia from the rapid administration of a concentrated glucose solution.
Bhatia
Anuj
A
Department of Anaesthesia and John V. Farman Intensive Care Unit, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, United Kingdom.
Cadman
Brit
B
Mackenzie
Iain
I
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000009:adverse effects*; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D006947:Hyperkalemia / Q000150:complications; D007003:Hypoglycemia / Q000209:etiology / Q000628:therapy*; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects
D001786:Blood Glucose; D007328:Insulin; D005947:Glucose