Diuretic-induced hypokalaemia inducing torsades de pointes

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
J P ChvilicekG E Hill

Abstract

Torsades de pointes (TP), an unique polymorphous type of ventricular tachycardia, is associated with either an acquired or congenitally prolonged QT interval. Several reports have demonstrated TP to follow an acquired prolonged QT interval secondary to chronic hypocalcaemia, hypomagnesaemia, or hypokalaemia. We report a rapid onset, acute extracellular hypokalaemia not associated with other electrolyte disturbances inducing a prolonged QT interval followed by TP. This is the first case report of a rapid onset isolated acute extracellular hypokalaemia inducing TP. Since anaesthetists are involved in therapies that will rapidly reduce extracellular potassium (diuretic, catecholamine, and/or insulin administration, hyperventilation), this cae report serves as a warning that such therapy may have the risk of arrhythmia induction.

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Citations

May 11, 2004·Journal of Electrocardiology·Oscar Díaz-CastroManuel Martínez-Selles
Aug 18, 2006·British Journal of Anaesthesia·G E HillE R Johnson
Dec 19, 2013·Trauma Monthly·Alireza BaratlooBehrooz Hashemi
Apr 10, 2010·Expert Opinion on Drug Safety·Pamela L SmithburgerSandra L Kane-Gill
Aug 25, 2012·The American Journal of Emergency Medicine·Suleyman ErcanVedat Davutoglu
Aug 5, 2003·Liver International : Official Journal of the International Association for the Study of the Liver·Jasdeep Singh Bal, Paul J Thuluvath
Nov 22, 2012·British Journal of Clinical Pharmacology·Geoffrey K Isbister, Colin B Page
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Aug 26, 2006·Anesthesia and Analgesia·Victor W XiaRandolph H Steadman
Apr 26, 2019·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Ingrid BerlingSophie Gosselin
Jun 8, 2013·Anesthesia and Analgesia·Joshua JohnstonPeter Nagele
Apr 20, 2004·Journal of Cardiovascular Electrophysiology·Robert R FenichelUNKNOWN Independent Academic Task Force

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