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Title: Survival after cardiopulmonary arrest with extreme hyperkalaemia and hypothermia in a patient with metformin-associated lactic acidosis.
Authors: Tay, Stan
Lee, I-Lynn
Affiliation: Department of Anaesthesia, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Issue Date: 20-Dec-2012
Citation: BMJ case reports 2012-12-20; 2012
Abstract: Potassium levels are regularly used as a prognostic factor to cease resuscitation in significant hypothermia. In this case report, we highlight how survival is still possible with extreme hyperkalaemia in severe hypothermia. We present a case of a 65-year-old Caucasian man who presented with metformin associated lactic acidosis. On presentation he had potassium of 9.1 mmol/l and a temperature of 31.5 °C. Cardiopulmonary resuscitation was commenced when he went into asystolic arrest. This presentation would commonly make attempts at resuscitation futile with a 100% death rate. However, with appropriate management this patient's condition improved and survival was possible. We provide evidence that survival is possible in profound hyperkalaemia and hypothermia. Effective cardiopulmonary resuscitation with early haemofiltration can be successful.
DOI: 10.1136/bcr-2012-007804
Type: Case Reports
Journal Article
Subjects: Acidosis, Lactic
Heart Arrest
Hypoglycemic Agents
Severity of Illness Index
Cardiopulmonary Resuscitation
Appears in Collections:NT Health digital library

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