[Pitfall in intraoperative electrolyte management for a patient with pseudohyperkalemia caused by thrombocytosis].
An 81-year-old woman was scheduled for gastrectomy due to advanced gastric cancer. Preoperative serum potassium concentration was 6.5 mEq x l(-1), and the operation was postponed. Renal function was normal and hematopathy was denied after bone marrow biopsy. But thrombocyte was 130.5 x 10(4) x mm(-3). Plasma potassium concentration was within normal ranges, and she was diagnosed as pseudohyperkalemia caused by thrombocytosis. Difference between serum and plasma potassium concentrations was more than 1 mEq x l(-1) throughout the surgery. We should take a blood plasma sample in patients with hyperkalemia combined with thrombosis, when renal function was within normal ranges and hemolysis was denied.
Department of Anesthesiology, Kansai Denryoku Hospital, Osaka 553-0003.
Masataka
M
Nomura
Masato
M
Nakasuji
Mitsuyo
M
Nakamura
Norie
N
Imanaka
Masuji
M
Tanaka
Hiroko
H
Kawashima
D000369:Aged, 80 and over; D000768:Anesthesia, General; D015415:Biomarkers / Q000097:blood; D005260:Female; D005743:Gastrectomy; D006801:Humans; D006947:Hyperkalemia / Q000175:diagnosis* / Q000209:etiology*; D007430:Intraoperative Care; D016343:Monitoring, Intraoperative; D011188:Potassium / Q000097:blood; D013274:Stomach Neoplasms / Q000601:surgery; D013922:Thrombocytosis / Q000150:complications*
D015415:Biomarkers; D011188:Potassium