Lesson of the Week: Hyperkalaemic cardiac arrest successfully treated with peritoneal dialysis

Abstract

Cardiac arrest caused by asystole, as a result of hyperkalaemia, is usually fatal. Resuscitation is often curtailed early because a successful outcome is unlikely. If the hyperkalaemia cannot be corrected electrical transmission is blocked to distal areas of the heart and asystole will persist.1 2 We report on a patient subsequently shown to have muscular dystrophy who was successfully treated with peritoneal dialysis after conventional pharmacological methods had failed. A 16 year old Asian man was admitted for a routine nasal septoplasty. He admitted that for several years he had had myalgia after exercise. He was not taking any medication and he had no history of allergies. There was no family history of any adverse reaction to anaesthesia. Examination at the time of admission showed nothing abnormal. Temazepam and metoclopramide were given as premedication. Propofol mixed with lignocaine and suxamethonium were used to facilitate intubation. Anaesthesia was maintained using isoflurane and a mixture of nitrous oxide and air. An electrocardiogram, oxygen saturation, and end tidal carbon dioxide were normal throughout the operation, …