[Fatal succinylcholine-induced hyperkalemia in an intensive care unit].
Succinylcholine-induced hyperkalemia is reported, but is still used in rapid sequence induction. In our case a 44 year-old man with septic shock was mechanically ventilated for 13 days, extubated but because of respiratory insufficiency reintubated. During induction an increase in p-potassium (4.2-11.7 mmol/l) caused ventricular fibrillation. Immobilization/infection cause an up-regulation and change in acetylcholine receptors is probably the reason for the extensive hyperkalemia and death. Caution in using succinylcholine is recommended and using rocuronium as an alternative is discussed.
Intensiv Afdeling 542, Hvidovre Hospital, 2650 Hvidovre, Denmark. benediktesf@yahoo.com
Benedikte
B
Frederiksen
Morten
M
Steensen
Peder
P
Carl
D000328:Adult; D017809:Fatal Outcome; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced*; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D008297:Male; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects*; D012307:Risk Factors; D013390:Succinylcholine / Q000009:adverse effects*
D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine