一名未被怀疑患有杜氏肌营养不良症的儿童在体外循环后发生高钾血症性心脏骤停。

Hyperkalemic cardiac arrest after cardiopulmonary bypass in a child with unsuspected duchenne muscular dystrophy.

作者信息

Nathan Aruna, Ganesh Arjunan, Godinez Rodolfo I, Nicolson Susan C, Greeley William J

机构信息

*Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia; and †Department of Anesthesia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

出版信息

Anesth Analg. 2005 Mar;100(3):672-674. doi: 10.1213/01.ANE.0000146533.21771.2F.

DOI:10.1213/01.ANE.0000146533.21771.2F

PMID:15728050

Abstract

Adverse reactions to volatile anesthetics and depolarizing muscle relaxants can occur in patients with Duchenne muscular dystrophy (DMD) resulting in acute rhabdomyolysis and hyperkalemia. We report a case of hyperkalemic cardiac arrest after cardiac surgery using cardiopulmonary bypass in a child with unsuspected DMD. Early diagnosis and management of hyperkalemia resulted in a successful outcome. Genetic testing confirmed the diagnosis of DMD. We recommend a thorough preoperative investigation, including creatine kinase estimation, in children with a history of unexplained motor delay.

摘要

患有杜氏肌营养不良症（DMD）的患者使用挥发性麻醉剂和去极化肌松药时可能会出现不良反应，导致急性横纹肌溶解和高钾血症。我们报告了1例患有未被怀疑患有DMD的儿童在心脏手术后使用体外循环发生高钾血症性心脏骤停的病例。高钾血症的早期诊断和处理取得了成功的结果。基因检测确诊了DMD。我们建议对有不明原因运动发育迟缓病史的儿童进行全面的术前检查，包括肌酸激酶评估。