| Cardiac Arrest due to Severe Hypokalemia during Barbiturate Coma Therapy in a Patient with Severe Acute Head Injury: A case report. |
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Il Woo Shin, Ju Tae Sohn, Ju Young Choi, Heon Keun Lee, Chul Hee Lee, Young Kyun Chung |
1Department of Anesthesiology and Pain Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea. jtsohn@nongae.gsnu.ac.kr
2Department of Neurosurgery, Gyeongsang National University College of Medicine, Jinju, Korea.
3Department of Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea. |
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| Abstract |
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An emergency left frontotemporal craniectomy with direct neck clipping and hematoma removal was performed in a 36-year-old man with a ruptured left middle cerebral artery aneurysm and sylvian hematoma. Because of severe brain swelling postoperatively, we induced barbiturate coma therapy to treat his intractable brain swelling. He had an initial loading dose of sodium thiopental (5 mg/kg) followed by continuous infusion of sodium thiopental (5 mg/kg/hour).
The lowest potassium concentration recorded during the barbiturate coma therapy was 1.1 mmol/L; necessitating treatment with cardiac massage, epinephrine, and atropine because of asystole and severe bradycardia. However, he did not recover from cardiac arrest. We present here a case of cardiac arrest due to severe life threatening hypokalemia that occurred during barbiturate coma therapy. |
| Key Words:
barbiturate coma; cardiac arrest; hypokalemia |
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