SUCCINYLCHOLINE-INDUCED HYPERKALEMIA FOLLOWING PROLONGED PHARMACOLOGICAL NEUROMUSCULAR BLOCKADE

While being treated for the acute respiratory distress syndrome, a 27- year-old woman developed profound hyperkalemia and cardiac arrest foll owing tile administration of succinylcholine chloride (SCh). She had n one of the risk factors previously described for development of severe hyperkalemia following SCh administrations; however, she had been int ermittently treated with nondepolarizing neuromuscular blocking drugs throughout the course of her illness. We suggest that immobilization o f critically ill patients with pharmacologic neuromuscular blockade ma y predispose them to severe hyperkalemia and cardiac arrest following administration of SCh. SCh should be used with great caution in such p atients.