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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Published on: September 20, 2018

BRASH Syndrome.

Sowdo Nur Iyow1, Abdisamad Mohamed Adam2, Hassan Adan Ali Adan1

  • 1Emergency Medicine Department Mogadishu Somali Türkiye Training and Research Hospital Mogadishu Somalia.

Clinical Case Reports
|June 8, 2026
PubMed
Summary
This summary is machine-generated.

BRASH syndrome, a dangerous condition of bradycardia, renal failure, AV blockade, shock, and hyperkalemia, can be reversed. Emergent hemodialysis effectively treated a patient with severe BRASH syndrome refractory to standard therapies.

Keywords:
AV nodal blockersBRASH syndromeacute kidney injurybradycardiacase reporthyperkalemia

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Area of Science:

  • Cardiology
  • Nephrology
  • Critical Care Medicine

Background:

  • BRASH syndrome is a critical condition involving bradycardia, renal failure, AV blockade, shock, and hyperkalemia.
  • It is often precipitated by AV nodal blocking agents in patients with acute kidney injury, creating a detrimental cycle.
  • Understanding this syndrome is vital for timely and effective patient management.

Purpose of the Study:

  • To present a case of BRASH syndrome in an elderly female patient.
  • To highlight the challenges in managing this condition with conventional treatments.
  • To demonstrate the efficacy of emergent hemodialysis in refractory BRASH syndrome.

Main Methods:

  • Case report of an 83-year-old female with chronic kidney disease and heart failure.
  • Clinical presentation included severe bradycardia, hyperkalemia, and shock.
  • Treatment involved emergent hemodialysis after failure of standard bradycardia interventions.

Main Results:

  • The patient presented with severe bradycardia (31 bpm) and hyperkalemia (6.9 mg/dL).
  • Standard treatments for bradycardia were ineffective.
  • Emergent hemodialysis led to significant clinical improvement.

Conclusions:

  • BRASH syndrome requires prompt recognition and management.
  • Emergent hemodialysis can be a life-saving intervention for refractory BRASH syndrome.
  • This case underscores the importance of considering hemodialysis in patients with severe, treatment-resistant BRASH syndrome.