From the Literature
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Mol Diagn Ther 2010; 14 (3): 195-203 1177-1062/10/0003-0195/$49.95/0
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From the Literature Case Reports-
Contents 1. Anesthetics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 2. Anti-Infectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196 3. Antineoplastics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198 4. Immunomodulators. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 5. Immunosuppressants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 6. Neurologic and Psychiatric Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 7. Obesity Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
1. Anesthetics Isoflurane: Cardiac Arrest Secondary to Rhabdomyolysis and Hyperkalemia in a Child: Case Report
A 12-year-old boy with previously undiagnosed Becker’s muscular dystrophy experienced perioperative heart arrest secondary to rhabdomyolysis and hyperkalemia after isoflurane anesthesia for circumcision. Anesthesia was induced with IV fentanyl and propofol, and was maintained with isoflurane, in oxygen and air, with a maximum MAC (minimum alveolar concentration) of 1.4. The anesthesia was 25 minutes in duration and uneventful. Postoperatively, the boy was breathing spontaneously, with an oxygen saturation of 99% on 5 L/min of oxygen. Approximately 10 minutes later, he had reduced consciousness and was making spontaneous respiratory effort while receiving supplemental oxygen. Electrocardiography showed a bradycardic sinus rhythm [time to reaction onset not clearly stated], with no improvement following IV atropine. His central pulses became impalpable, and CPR was commenced. Venous blood analysis 20 minutes after the arrest showed acidosis, severe hyperkalemia, and hypocalcemia. The hyperkalemia was treated with IV
sodium bicarbonate, insulin/dextrose, calcium, and salbutamol infusions. CPR was continued until the hyperkalemia was corrected. Regular cardiac rhythm and output were restored 105 minutes after the arrest. He was transferred to an adult ICU, where his serum creat
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