Hypokalaemia and refractory asystole complicating diabetic ketoacidosis, lessons for prevention
Summary We report a unique case of diabetic ketoacidosis in which a relatively low potassium level on admission was associated with consequent life-threatening and refractory arrhythmia secondary to inappropriate use of intravenous insulin and bicarbonate therapy. The latter was reversed by rapid bo...
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Published in | BMJ case reports Vol. 2012; p. bcr-2012-007312 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
England
BMJ Publishing Group LTD
05.12.2012
BMJ Publishing Group |
Series | Reminder of important clinical lesson |
Subjects | |
Online Access | Get full text |
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Summary: | Summary We report a unique case of diabetic ketoacidosis in which a relatively low potassium level on admission was associated with consequent life-threatening and refractory arrhythmia secondary to inappropriate use of intravenous insulin and bicarbonate therapy. The latter was reversed by rapid bolus potassium injection. Although we do not advocate this approach in every case, we emphasise that a bolus injection of potassium may be life saving in such cases. The lessons from this case have led to multidisciplinary meetings and modification of the institute's diabetic ketoacidosis clinical pathway. |
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ISSN: | 1757-790X 1757-790X |
DOI: | 10.1136/bcr-2012-007312 |