Life-Threatening Dyskalaemia after Barbiturate Coma Therapy: The Strategy of Management
- Author:
Yeap Boon Tat
;
Wan Mohd Nazaruddin Wan Hassan
;
Ting Yung Chuen
- Publication Type:Journal Article
- Keywords:
barbiturate coma, intracranial hypertension, hypokalemia, hyperkalemia, thiopentone
- From:Malaysian Journal of Medical Sciences
2017;24(2):100-105
- CountryMalaysia
- Language:English
-
Abstract:
Barbiturate coma therapy (BCT) is a treatment option that is used for refractory
intracranial hypertension after all other options have been exhausted. Although BCT is a brain
protection treatment, it also has several side effects such as hypotension, hepatic dysfunction,
renal dysfunction, respiratory complications and electrolyte imbalances. One less concerning
but potentially life-threatening complication of BCT is dyskalaemia. This complication could
present as severe refractory hypokalaemia during the therapy with subsequent rebound
hyperkalaemia after cessation of the therapy. Judicious potassium replacement during severe
refractory hypokalaemia and gradual cessation of the therapy to prevent rebound hyperkalaemia
are recommended strategies to deal with this complication, based on previous case series and
reports. In this case report, we show that these strategies were applicable in improving severe
hypokalaemia and preventing sudden, life-threatening rebound hyperkalaemia. However,
even with use of these strategies, BCT patients could still present with mild, asymptomatic
hyperkalaemia.
- Full text:P020170508604134936196.pdf
