Outcomes of severe hyperkalemia in cardiopulmonary resuscitation with concomitant hemodialysis
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To investigate the efficacy of hemodialysis during cardiopulmonary resuscitation as an effective adjunct to the treatment of severe hyperkalemia.
A prospective study.
In hospital dialysis units and intensive care units.
Renal failure patients who developed hyperkalemia induced cardiac arrest and failed to recover from conventional cardiopulmonary resuscitation (CPR) were included. Three patients entered into this study: 2 patients with chronic renal failure maintained on regular hemodialysis and one with acute renal failure who suffered from severe hyperkalemia.
All three patients developed asystolic cardiac arrest with unrecordable blood pressure due to severe hyperkalemia. Aggressive CPR together with intravenous epinephrine, sodium bicarbonate and calcium chloride were instituted. External cardiac massage with cardiac defibrillation was unable to restore spontaneous heart action. After lack or response to intensive resuscitation, hemodialysis was performed concomitant with CPR to eliminate the potassium load.
Measurements and results
Sinus rhythm and blood pressure were restored in all 3 patients but one of them eventually succumbed to her underlying disease.
Hemodialysis during CPR is probably an effective adjunct to the treatment of severe hyperkalemia in patients with severe hemodynamic compromise and asystolic cardiac arrest.
Tannen RL (1986) Potassium disorders. In: Kokko JP, Tannen RL (eds) Fluid and electrolytes. Saunders, Philadelphia, pp 150–228
Del Guercio LRM, Feins NR, Cohn JD, Coomaraswarmy RP, Wollman SB, State D (1965) Comparison of blood flow during external and internal cardiac massage in man. Circulation 31/32 [Suppl 1]:1-171—I-180
Rinke CM (1986) Standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care. Part II: Adult basic life support. JAMA 255:2915–2932
Weale FE, Rothwell-Jackson RL (1962) The efficiency of cardiac massage. Lancet I:990–992
Mackenzie GJ, Taylor SH, MacDonald AH, Donald KW (1964) Hemodynamic effects of external cardiac compression. Lancet I:1342–1345
Niemann JT (1992) Cardiopulmonary resuscitation. N Eng J Med 327:1075–1080
Birch LH, Kenney LJ, Doornbos F et al (1962) A study of external cardiac compression. J Mich State Med Soc 61:1346–1352
Maier GW, Tyson GS Jr, Olsen Co et al (1980) The physiology of external cardiac massage: high impulse cardiopulmonary resuscitation. Circulation 70:86–101
Taylor GJ, Tucker WM, Greene HL, Rudikoff MT, Weisfeldt ML (1977) Importance of prolonged compression during cardiopulmonary resuscitation in man. N Engl J Med 296:1515–1517
Rudikoff MT, Maughan WL, Effron M, Freund P, Weisfeldt ML (1980) Mechanism of blood flow during cardiopulmonary resuscitation. Circulation 61:345–352
Niemann JT, Rosborough JP, Hausknecht M, Garner D, Criley JM (1981) Pressure-synchronized cineangiography during experimental cardiopulmonary resuscitation. Circulation 64:985–991
Weisfeldt ML, Chandra N (1981) Physiology of cardiopulmonary resuscitation. Ann Rev Med 32:435–442
Deshmukh HG, Weil MH, Gudipati CV, Trevino RP, Bisera J, Rackow EC (1989) Mechanism of blood flow generated by precordial compression during CPR. I. Studies on closed chest precordial compression. Chest 95:1092–1099
Feneley MP, Maier GW, Gaynor JW, Gall SA, Kisslo JA, Davis JW, Rankin JS (1987) Sequence of mitral valve motion and transmitral blood flow during manual cardiopulmonary resuscitation in dogs. Circulation 76:363–375
Lin JL, Huang CC (1990) Successful initiation of hemodialysis during cardiopulmonary resuscitation due to lethal hyperkalemia. Crit Care Med 18:342–343
Defronzo RA, Bia M, Smith D (1982) Clinical disorders of hyperkalemia. Ann Rev Med 33:521–530
- Outcomes of severe hyperkalemia in cardiopulmonary resuscitation with concomitant hemodialysis
Intensive Care Medicine
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