scholarly journals Safety of perioperative period in robot-assisted atrial septal defect repair under hyperkalemic arrest

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kazuto Miyata ◽  
Tatsuya Tarui ◽  
Sayaka Shigematsu ◽  
Norihiko Ishikawa ◽  
Go Watanabe
Keyword(s):  
Atrial Septal Defect ◽  
Serum Potassium ◽  
Perioperative Management ◽  
Septal Defect ◽  
Potassium Concentration ◽  
Cardiac Complications ◽  
Robot Assisted ◽  
Robotic Assisted ◽  
Serum Potassium Concentration ◽  
Bladder Temperature

Abstract Background Various attempts have been made to meet patient desires, especially among younger and otherwise healthy individuals, for cosmetically satisfying incision with atrial septal defect (ASD) repair. One of procedures was a robotic-assisted totally endoscopic ASD repair via only two ports under hyperkalemic arrest without aortic cross-clamping. This study investigated perioperative management and safety for robotic-assisted total endoscopic ASD repair surgery under hyperkalemic arrest. Methods We retrospectively reviewed perioperative management of thirty patients who underwent total endoscopic robot-assisted ASD repair under hyperkalemic arrest. All procedures were performed under general anesthesia using robotic-assisted total endoscopic for ASD repair via two or three ports under hyperkalemic arrest without aortic cross-clamping. Results A total of 30 patients (mean age 45 ± 17 years, 8 male, 22 female) underwent successful ASD repair with the total endoscopic robotic-assisted procedures under hyperkalemic arrest. Hyperkalemic arrest was achieved and maintained by intravenous administration of mean potassium dose of 91±32 mEq (1.4±0.6 mEq/kg) with the lowest bladder temperature was 31.9±1.4 °C during hyperkalemic arrest. In all cases, serum potassium concentration was <5.0 mEq/L after weaning from cardiopulmonary bypass, although two cases who developed hyperkalemia >6 mEq/L after operation. At other time points, no patient exceeded 6 mEq/L of serum potassium concentration. At admission to the intensive care unit, mean serum creatine phosphokinase-MB level was 32±7mg/dL. There were no cases of arrhythmia or other cardiac complications during recovery. Conclusions Perioperative management of robotic-assisted total endoscopic ASD repair under hyperkalemic arrest is safe and is not associated with fatal arrhythmia due to hyperkalemia.

scholarly journals Correcting hypokalaemia in a paediatric patient with Bartter syndrome through oral dose of potassium chloride intravenous solution

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110197
Author(s):  
Salman Alasfour ◽  
Haya S Alfailakawi ◽  
Yousif A Shamsaldeen
Keyword(s):  
Paediatric Patient ◽  
Potassium Chloride ◽  
Serum Potassium ◽  
Nasogastric Tube ◽  
Potassium Concentration ◽  
Oral Route ◽  
Bartter Syndrome ◽  
Intravenous Route ◽  
Serum Potassium Concentration ◽  
Main Challenge

Bartter syndrome is a rare autosomal recessive disorder characterized by hypokalaemia. Hypokalaemia is defined as low serum potassium concentration ˂3.5 mmol/L, which may lead to arrhythmia and death if left untreated. The aim of this case report was to normalize serum potassium concentration without the need for intravenous intervention. A 5-month-old male of 2.7 kg body weight diagnosed with Bartter syndrome was admitted to the general paediatric ward with acute severe hypokalaemia and urinary tract infection. The main challenge was the inability to administer drugs through intravenous route due to compromised body size. Therefore, we shifted the route of administration to the nasogastric tube/oral route. A total of 2 mL of concentrated intravenous potassium chloride (4 mEq potassium) were dissolved in distilled water and administered through nasogastric tube. Serum potassium concentration was rapidly normalized, which culminated in patient discharge. In conclusion, shifting drug administration from intravenous to oral route in a paediatric patient with Bartter syndrome includes numerous advantages such as patient convenience, minimized risk of cannula-induced infection, and reduced nurse workload.

Serum Potassium Concentration and Use of Ouabain in Experimental Tourniquet Shock

1957 ◽  
Vol 189 (3) ◽  
pp. 605-608 ◽  
Author(s):  
W. F. Rosse ◽  
A. L. Bennett ◽  
A. R. McIntyre
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Potassium Concentration ◽  
Mean Blood Pressure ◽  
Serum Potassium Concentration ◽  
Average Value ◽  
Tourniquet Shock ◽  
The Mean

Shock was induced in dogs by the release of tourniquets which had been applied to the hind legs for 5 hours. The serum potassium level was followed by spaced sampling. It was seen to rise slightly (from an average of 4.02 mEq/l. to an average of 4.66 mEq/l.) during the prerelease period. Five minutes after the release of the tourniquets, the level had risen to an average of 7.50 mEq/l. and thirty minutes after the release, it had risen to an average of 8.56 mEq/l. At the critical point in the progress of the syndrome (when the mean blood pressure was approximately 50 mm Hg) the average value was 8.46 mEq/l. Ouabain was administered and the level of serum potassium was seen to rise, attaining values as high as 14.67 mEq/l. in one case. The results and significance of these increased levels are briefly discussed as well as an animadversion upon the effects of ouabain on the mean blood pressure.

scholarly journals No-touch aorta robot-assisted atrial septal defect repair via two ports

2018 ◽  
Vol 26 (5) ◽  
pp. 721-724 ◽  
Author(s):  
Norihiko Ishikawa ◽  
Go Watanabe ◽  
Tatsuya Tarui
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Robot Assisted ◽  
Defect Repair

Acid-Activated Renin Responses to Hydrochlorothiazide, Propranolol and Indomethacin

1978 ◽  
Vol 55 (s4) ◽  
pp. 151s-153s ◽  
Author(s):  
J. K. McKenzie ◽  
E. Reisin
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Potassium Concentration ◽  
Hypertensive Patients ◽  
Serum Potassium Concentration ◽  
Active Renin ◽  
Serum Aldosterone ◽  
Low Salt ◽  
Inactive Renin ◽  
Marked Suppression

1. Six essential hypertensive patients (five with low renin) were treated in successive weeks with placebo; hydrochlorothiazide 100 mg (382 μmol)/day; hydrochlorothiazide and 50 mmol of sodium/day diet; hydrochlorothiazide, 50 mmol of sodium diet and propranolol 160 mg (544 μmol)/day; and hydrochlorothiazide, 50 mmol of sodium and indomethacin 100 mg (287 μmol)/day. 2. Although blood pressure remained unchanged and serum potassium fell on diuretic with or without low salt, there was a marked increase of active renin and a lesser increase of inactive renin, resulting in an increased proportion of active to total renin. 3. Propranolol decreased both active and inactive renin, but not significantly. 4. Indomethacin produced a marked suppression of active renin, a smaller reduction in inactive renin, and a reduction of the ratio of active to total renin almost to placebo values. 5. Blood pressure rose to control values on indomethacin despite the fall in renin whereas it fell with propranolol with little change in renin. 6. Serum aldosterone rose with stimulation but remained elevated despite effective renin suppression with indomethacin and continuing reduced serum potassium concentration.

Effects of acute hypothermia and β-adrenergic receptor blockade on serum potassium concentration in rats

1991 ◽  
Vol 19 (12) ◽  
pp. 1545-1551 ◽  
Author(s):  
JURAJ SPRUNG ◽  
EUGENE Y. CHENG ◽  
STJEPAN GAMULIN ◽  
JOHN P. KAMPINE ◽  
ZELJKO J. BOSNJAK
Keyword(s):  
Serum Potassium ◽  
Adrenergic Receptor ◽  
Potassium Concentration ◽  
Receptor Blockade ◽  
Serum Potassium Concentration ◽  
Adrenergic Receptor Blockade
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