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Published on: March 15, 2020
Life-threatening hyperkalemia during radiofrequency ablation of hepatocellular carcinoma
Julia Metzner1, Jennifer L Evans, Karen B Domino
1Department of Anesthesiology and Pain Medicine, Box 356540, University of Washington School of Medicine, Seattle, WA 98195-6540, USA. metznj@u.washington.edu
Abstract:
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.
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