An unusual case of intraoperative hyperkalemia

Abstract

Objective To report a rare case of intraoperative hyperkalemia and share our experience in the diagnosis and treatment with colleagues. Methods We reported 1 case of intraoperative hyperkalemia caused by central venous occlusion, auto-circulation of dialysis circuit and incomplete dialysis, the manifestation and treatment were summarized. Results Hyperkalemia is common in patients dependent on hemodialysis, and is a life-threatening complication. Electrocardiogram was not sensitive to hyperkalemia and the manifestations of intraoperative hyperkalemia are atypical, making the diagnosis difficult. After intravenous administrator of calcium and insulin,correction of acidosis and the application of continuous renal replacement therapy (CRRT), the patient started peritoneal dialysis gradually. Conclusions For patients who are dependent on hemodialysis and complicated with the failure of vascular access, incomplete dialysis is possible and peritoneal dialysis should be considered.

Keywords

• hyperkalemia|maintenance dialysis|vascular access