Korean J Anesthesiol.  2019 Apr;72(2):178-183. 10.4097/kja.d.17.00075.

Combination of extracorporeal membrane oxygenation and in-line hemofiltration for the acute hyperkalemic cardiac arrest in a patient with Duchenne muscular dystrophy following orthopedic surgery: a case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea. mdmole@chosun.ac.kr
  • 2Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea.

Abstract

BACKGROUND
Duchenne muscular dystrophy (DMD) is the most common childhood muscular dystrophy that anesthesiologists can encounter in the operation room, and patients with DMD are susceptible to complications such as rhabdomyolysis, hyperkalemic cardiac arrest, and hyperthermia during the perioperative period. Acute onset of hyperkalemic cardiac arrest is a crisis because of the difficulty in achieving satisfactory resuscitation owing to the sustained hyperkalemia accompanied by rhabdomyolysis. CASE: We here report a case of a 13-year-old boy who had multiple leg fractures and other trauma after a car accident and who had suffered from acute hyperkalemic cardiac arrest. He was refractory to cardiopulmonary resuscitation and showed sustained hyperkalemia. With extracorporeal membrane oxygenation and in-line hemofiltration, he recovered from repeated cardiac arrest and hyperkalemia.
CONCLUSIONS
Combining ECMO and in-line hemofiltration might be a safe and effective technique for refractory hyperkalemic cardiac arrest and rhabdomyolysis in patients with DMD.

Keyword

Cardiac arrest; Cardiopulmonary resuscitation; Duchenne muscular dystrophy; Extracorporeal membrane oxygenation; Hemofiltration; Hyperkalemia; Rhabdomyolysis

MeSH Terms

Adolescent
Cardiopulmonary Resuscitation
Extracorporeal Membrane Oxygenation*
Fever
Heart Arrest*
Hemofiltration*
Humans
Hyperkalemia
Leg
Male
Muscular Dystrophies
Muscular Dystrophy, Duchenne*
Orthopedics*
Perioperative Period
Resuscitation
Rhabdomyolysis
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