Life-threatening hyperkalemia during radiofrequency ablation of hepatocellular carcinoma.
A 48 year-old man with hepatitis C and cirrhosis was admitted for laparoscopic radiofrequency ablation of a large hepatocellular carcinoma. The patient's renal function tests and serum potassium level were all within normal limits. About 120 minutes into the procedure, the patient developed sudden, wide-complex tachycardia. Initial blood tests showed serum and plasma potassium level of 7 mEq/L, but no other abnormalities. The thermal destruction of large tumors during radiofrequency ablation may be associated with extensive cell breakdown and transcellular shift of potassium.
Metzner
Julia
J
Department of Anesthesiology and Pain Medicine, Box 356540, University of Washington School of Medicine, Seattle, WA 98195-6540, USA. metznj@u.washington.edu
Evans
Jennifer L
JL
Domino
Karen B
KB
D006528:Carcinoma, Hepatocellular / Q000601:surgery; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D006947:Hyperkalemia / Q000209:etiology* / Q000473:pathology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008103:Liver Cirrhosis / Q000209:etiology; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013610:Tachycardia / Q000209:etiology