LIFE-THREATENING REPERFUSION INJURY IN SKELETAL-MUSCLE - A SIMPLE TECHNIQUE TO CONTROL CRITICAL HYPERKALEMIA

A 55-year-old male suffering from acute abdominal aortic occlusion due to iatrogenic aortic dissection was urgently admitted to hospital. An axillo-bifemoral bypass was constructed 6 hours from the onset of dis section. Before and after revascularization, blood samples were repeat edly obtained from a systemic artery and femoral vein. The arterial po tassium concentration gradually increased, reaching 7.3 mM/L. Oliguria and arrhythmias occurred, and the left lower Limb became rigid 3 hour s after reperfusion. The femoral artery and vein were clamped and with in 30 minutes, the arterial potassium concentration fell to 4.8 mM/L. The urine output increased. The left lower limb was amputated, and the patient survived. Immediately following revascularization, hyperkalem ia may occur. Clamping of the afferent and efferent vessels is recomme nded as a simple and practical technique to quickly control life-threa tening hyperkalemia.