1.
Life-threatening acute water intoxication in a woman undergoing hysteroscopic myomectomy: a case report and review of the literature.
Liao, CY, Lo, CH, Yu, MX, Chan, WH, Wei, KY, Tseng, MF, Wu, CC
BMC women's health. 2020;(1):52
Abstract
BACKGROUND Acute water intoxication after hysteroscopy is a rare, life-threatening condition, often accompanied with delayed diagnosis owing to masked symptoms because of general anesthesia. CASE PRESENTATION Herein we presented a 39-year-old female who presented with cardiac arrest after hysteroscopic myomectomy because of acute water intoxication and survived after extracorporeal membrane oxygenation, continuous venous-venous hemofiltration, and aggressive high sodium fluid resuscitation. CONCLUSION Failure to recognize and treat this condition appropriately may lead to potentially lethal cardiopulmonary complications.
2.
Expanded Criteria Donor-Related Hyperkalemia and Postreperfusion Cardiac Arrest During Liver Transplantation: A Case Report and Literature Review.
Zhang, L, Tian, M, Wei, L, Zhu, Z
Annals of transplantation. 2018;:450-456
Abstract
BACKGROUND Liver transplantation (LT) using extended criteria donor (ECD) grafts is frequently associated with a high flush fluid potassium concentration (FFK) and acute hyperkalemia after reperfusion, which puts patients at greater risk of postreperfusion cardiac arrest (PRCA). CASE REPORT Herein, we present a case with an extremely high FFK that was successfully pretreated to avoid the risk of PRCA. A 3-year-old boy with biliary atresia underwent LT from a 623-g donation after brain death liver graft with localized frostbite on the right lobe surface. The FFK was 18.8 mmol/L after flushing with 1000 mL of 5% albumin. To prevent PRCA due to acute hyperkalemia, further portal vein (PV) flush, retrograde reperfusion via the inferior vena cava, and antegrade reperfusion via the PV were adopted to remove the excessive potassium ions. Ultimately, the liver graft was reperfused when the perfused blood potassium concentration was 7.5 mmol/L without subsequent development of PRCA during the immediate reperfusion period. Nevertheless, the patient still experienced vasoplegic syndrome during the late reperfusion period. CONCLUSIONS Our case illustrates that the FFK measurement is helpful for identifying ECD-related hyperkalemia and for providing advance warning of PRCA. Future investigations are warranted to confirm the relationship between high FFK and PRCA and to observe the effectiveness of other interventions to prevent PRCA due to ECD-related hyperkalemia.
3.
Biomarkers of myocardial injury after cardiac arrest or myocardial ischemia.
Ristagno, G, Santonocito, C, Li, Y, Li Volti, G, Gullo, A
Frontiers in bioscience (Scholar edition). 2010;(1):373-91
Abstract
Outcomes of victims of cardiac arrest or acute myocardial ischemic events have improved with advances in medical therapy. Heart failure, however, remains a leading cause of morbidity and mortality after these conditions have occurred. Clinical features may be useful for predicting patients who are at risk of developing such complications, but they lack of sensitivity and specificity. Biomarkers have been therefore suggested as means to provide relevant prognostic information. The more commonly used biomarkers after cardiovascular ischemic events, including cardiac arrest, are creatin kinases and troponins. In addition, natriuretic peptides and C-reactive protein have gained great interest and now sufficient data has been collected such to justify their clinical applicability. Finally, several other novel biomarkers, to be used after resuscitation from cardiac arrest or more generally after a myocardial ischemic event, have been anticipated. Nevertheless, the "perfect" biomarker, able to provide diagnosis and prognosis with high sensitivity and specificity does not exit. A multimarker strategy that categorizes patients based on the number of elevated biomarkers at presentation is therefore suggested.
4.
Cardiac arrest in dialysis patients: approaches to alter an abysmal outcome.
Herzog, CA
Kidney international. Supplement. 2003;(84):S197-200
-
-
Free full text
-
Abstract
Cardiac disease is the major cause of death in dialysis patients, accounting for 45% of all-cause mortality. Sudden cardiac death may be implicated in 60% of these cardiac deaths in dialysis patients. The combination of obstructive coronary artery disease, electrolyte shifts (in hemodialysis patients), left ventricular hypertrophy, and abnormal myocardial ultrastructure and function may contribute to the vulnerability of ESRD patients to sudden death. In this review, the epidemiology of cardiac arrest in dialysis patients is presented, including the high lethality associated with cardiac arrest. Clinical strategies to reduce the likelihood of fatal cardiac arrest include the identification of high-risk patients, alteration of dialysis prescription to avoid large volume and electrolyte shifts, and reduction of myocardial ischemic burden. Implantable cardioverter defibrillators may potentially reduce the risk of fatal cardiac arrest in dialysis patients and improve long-term cardiac survival.