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间歇性血液透析对一名危重症COVID-19患者无效:一例持续性肝素诱导的高钾血症病例

Ineffectiveness of Intermittent Hemodialysis in a Critically Ill COVID-19 Patient: A Case of Persistent Heparin-Induced Hyperkalemia.

作者信息

Nlandu Yannick M, Engole Yannick M, Mboliassa Marie-France I, Sakaji Théodore-Junior M, Kobo Patrick U, Boloko Patrick M, Mafuta Pally K, Tsangu Joseph P, Van Echkout Karel, Kanku Jean-Pierre M, Kalifa Golan, Ahmed Rodolphe, Bukabau Justine B

机构信息

Intensive Care Unit, Centre Médical de Kinshasa, Kinshasa, Democratic Republic of the Congo.

Nephrology Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo.

出版信息

Case Rep Nephrol. 2022 Mar 4;2022:8613656. doi: 10.1155/2022/8613656. eCollection 2022.

Abstract

Heparin is widely used in the intensive care unit despite the risk of bleeding it can cause. Although it is rarely reported, hyperkalemia is one of the side effects associated with heparin therapy (unfractionated or fractionated heparin). It would be secondary to hypoaldosteronism by blocking the biosynthesis of aldosterone in the adrenal gland and often appears in context of prolonged heparin therapy or inappropriate renin production in elderly, diabetic, and kidney insufficiency patients. We report a case of persistent hyperkalemia in a diabetic COVID-19 patient treated with curative heparin in the context of severe COVID-19.

摘要

尽管肝素会有导致出血的风险,但它在重症监护病房仍被广泛使用。高钾血症是肝素治疗(普通肝素或低分子肝素)相关的副作用之一,虽然很少被报道。它继发于肾上腺醛固酮生物合成受阻导致的醛固酮减少症,常出现在长期肝素治疗的情况下,或在老年、糖尿病和肾功能不全患者中肾素分泌异常时。我们报告了一例重症新型冠状病毒肺炎(COVID-19)患者在接受肝素治疗时出现持续性高钾血症的病例。

相似文献

3
Heparin-induced hyperkalemia.
DICP. 1990 Mar;24(3):244-6. doi: 10.1177/106002809002400305.
7
Heparin-induced aldosterone suppression and hyperkalemia.
Am J Med. 1995 Jun;98(6):575-86. doi: 10.1016/s0002-9343(99)80017-5.
8
Hyperkalemia in the elderly.老年人高钾血症
Am J Kidney Dis. 1990 Oct;16(4):296-9. doi: 10.1016/s0272-6386(12)80005-9.

本文引用的文献

4
Management of hyperkalemia in the acutely ill patient.急重症患者高钾血症的管理
Ann Intensive Care. 2019 Feb 28;9(1):32. doi: 10.1186/s13613-019-0509-8.
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Refractory hyperkalemia related to heparin abuse.与肝素滥用相关的难治性高钾血症。
Indian J Crit Care Med. 2013 Nov;17(6):388-91. doi: 10.4103/0972-5229.123463.
7
Effects of pH on potassium: new explanations for old observations.pH 值对钾的影响:对旧观察结果的新解释。
J Am Soc Nephrol. 2011 Nov;22(11):1981-9. doi: 10.1681/ASN.2011040414. Epub 2011 Oct 6.

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