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[Three cases of hyperkalemia after reperfusion associated with revascularization for massive acute arterial
A Arakura1, K Hara, C Nishimura
1Department of Anesthesiology, Iida Municipal Hospital, Nagano, Japan.
Abstract:
We encountered three cases of hyperkalemia after the reperfusion of ischemic limbs associated with revascularization surgery for acute arterial occlusions. Two patients died because of uncontrollable hyperkalemia in spite of intravenous insulin and forced diuresis. Careful attention should be paid to hyperkalemia and metabolic acidosis for several hours after the reperfusion in cases of ischemia and/or extensive ischemia of long duration. The aggressive prophylaxis and treatment for MNMS are vital to the anesthetic management of revascularization for acute arterial occlusions.