Significant hyperkalemia after discontinuation of an insulin pump.
Patients with diabetes and insulin pumps may need their insulin therapy modified during surgery. Often, this is done with blood glucose as the end point. Changing insulin therapy can also have profound effects on potassium homeostasis in certain patients. This case demonstrates that changes in insulin therapy warrant not only close monitoring of blood glucose, but also of serum potassium. This patient's comorbidities and treatments that could alter potassium homeostasis are also reviewed.
Groudine
Scott B
SB
Department of Anesthesiology A-131, Albany Medical Center, Albany, NY 12208, USA. groudis@mail.amc.edu
Phan
Bick
B
D000328:Adult; D000768:Anesthesia, General / Q000379:methods; D001786:Blood Glucose / Q000032:analysis; D002405:Catheterization, Central Venous / Q000379:methods; D020878:Device Removal / Q000009:adverse effects*; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy* / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015918:Infusion Pumps, Implantable; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D011188:Potassium / Q000097:blood; D012965:Sodium Chloride / Q000008:administration & dosage
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D012965:Sodium Chloride; D011188:Potassium