Hyperkalemic circulatory shock and cardiac arrest altered by therapeutic management: A case report

Abstract

Hyperkalemia is one of the few potentially lethal electrolyte disturbances. Severe hyperkalemia (Serum potassium concentration > 6.5 mmol/L) occurs most commonly from renal failure or the release of potassium from cells and can cause circulatory shock, cardiac arrhythmias or cardiac arrest. Current BLS (Basic Life Support) and ACLS (Advanced Cardiovascular Life Support) protocol should be used to manage cardiac arrest associated with hyperkalemia. But early consideration should be given to using the selective method of therapeutic management in addition to standard ACLS protocols that can be provided rapidly, effectively in patients with cardiovascular instability. We describe here a case of chronic kidney disease and congestive heart failure who developed circulatory shock and eventually cardiac arrest due to hyperkalemia managed with Calcium Gluconate, Sodium Bicarbonate and Insulin along with standard advanced cardiovascular life support protocol. Keywords: Potassium, hyperkalemia, acidosis, calcium, insulin, cardiac arrest.