Avtor/Urednik		Lainščak, Mitja; Horvat, Štefan
Naslov		Huda iatrogena hiperkalemija po zdravljenju hipokalemije
Prevedeni naslov		Severe iatrogenic hyperkaliemia after treatment of hypokalemia
Tip		članek
Vir		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja. Zbornik 10. mednarodni simpozij o urgentni medicini; 2003 jun 11-14; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Leto izdaje		2003
Obseg		str. 199-203
Jezik		slo
Abstrakt		Introduction. Hyperkalenmia is a rare finding in normal subject. It is associated with increased intake, potassium shift from cells to extracellular fluid, and decreased urine excretion. Patients present with muscle weakness and typical electrocardiographic changes: peaked T waves, shortened QT interval, decreased amplitude, widening and loss of P waves, widening of QRS complex, sinewave pattern, followed by ventricular fibrillation or standstill. Antagonism of membrane actions, inereased entry of potassium into cells, and removal of potassium excess are the basics of hyperkalemia treatment. Case. Eighty-four years old woman was admitted due to elevated body temperature, abdominal pain, and diarrhoe. Previously she was treated with enalapril 5mg bid and metildigoxin. We found hypokaliemia (3.1 mmol/L) and normal renal function. We treated her with Kalinor 2 tablets tid and enalapril 10mg bid. On the second day she was free of any subjective complaint but on the foutrh day she developed diarrhoe and muscle weakness. We found her dehydrated, hypotensive, pale and bradycardic with rate 30/min. Eelectrocardiogram showed bradycardia (35/min) with wide QRS complex and absence of P waves. latrogenic hyperkalemia was suspected and she was treated with 10% calcium gluconate, glucose, insulin, and calcium polystirenesulphate. Hyperkalemia (10.6 mmol/L) and decreased renal function (urea 10.6 mmol/L; creatinine 134 Nmol/L) were confirmed. Due to dehydration (CVP -2cm Hz0) she was parenteraly hydrated with glucose and, when CVP was in normal range; furosemide. After three hours she was still in hyperkalemia (8.0 mmol/L), while in twelve hours there were no changes in electrocardiogram, patient was free of muscle weakness. Hemodyafisis was not performed as patient recovered completely with other treatment. (Abstract truncated at 2000 characters)
Deskriptorji		HYPOKALEMIA IATROGENIC DISEASE HYPERKALEMIA AGED POTASSIUM