一名新冠肺炎患者在使用氯化琥珀胆碱进行再次插管后因严重高钾血症导致心脏骤停。病例报告
Sudden Cardiac Arrest in a Patient With COVID-19 as a Result of Severe Hyperkalemia After Administration of Succinylcholine Chloride for Reintubation. A Case Report.
作者信息
Putowski Mateusz, Drygalski Tomasz, Morajda Andrzej, Woroń Jarosław, Sanak Tomasz, Wordliczek Jerzy
机构信息
Center for Innovative Medical Education, Jagiellonian University Medical College, Cracow, Poland.
Department of Anesthesiology and Intensive Care, University Hospital in Krakow, Krakow, Poland.
出版信息
Front Med (Lausanne). 2022 May 11;9:843282. doi: 10.3389/fmed.2022.843282. eCollection 2022.
BACKGROUND
We present a case study of a man with coronavirus disease 2019 (COVID-19) who developed cardiac arrest as a result of hyperkalemia following administration of chlororsuccinylcholine during endotracheal intubation.
CASE SUMMARY
A patient with a severe course of COVID-19, hospitalized in the Intensive Care Unit, underwent reintubation on day 16. The applied scheme was rapid sequence induction and intubation with administration of chlororsuccinylcholine. Immediately after intubation, there was a sudden cardiac arrest due to hyperkalemia (cK + 10.2 meq/L). Treatment was initiated as per guidelines, which resulted in a return to spontaneous circulation after 6 min.
CONCLUSION
Chlorsucynylcholine may cause life-threatening hyperkalemia. We recommend using rocuronium as a neuromuscular blocking agent in critically ill COVID-19 patients due to its more optimal safety profile.
背景
我们报告一例2019冠状病毒病（COVID-19）男性患者的病例研究，该患者在气管插管期间因使用氯琥珀胆碱后发生高钾血症而导致心脏骤停。
病例摘要
一名患有重症COVID-19的患者在重症监护病房住院，于第16天接受再次插管。采用的方案是快速顺序诱导并使用氯琥珀胆碱进行插管。插管后立即因高钾血症（血钾10.2毫当量/升）发生心脏骤停。按照指南开始治疗，6分钟后恢复自主循环。
结论
氯琥珀胆碱可能导致危及生命的高钾血症。由于罗库溴铵具有更优的安全性，我们建议在重症COVID-19患者中使用罗库溴铵作为神经肌肉阻滞剂。
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