Year : 2022  |  Volume : 16  |  Issue : 4  |  Page : 494-496

Incidental finding of severe hyperkalemia in a patient with end-stage renal disease during video-assisted lung lobectomy: A case report

1 Department of Anesthesiology, Far-Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan
2 Department of Anesthesiology, Far-Eastern Memorial Hospital, Banqiao, New Taipei; Department of Mechanical Engineering, Yuan Ze University, Chung-Li, Zhongli, Taoyuan, Taiwan

Correspondence Address:
Chia-Ying Chang
Department of Anesthesiology, Far-Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City 220
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.sja_274_22

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Patients with end-stage renal disease are at risk of developing hyperkalemia and acidosis, both of which have disastrous sequelae during elective video-assisted thoracic surgery for lung cancer. Herein, we present a case where severe hyperkalemia and combined acidosis were incidentally found in a 68-year-old man with the end-stage renal disease after establishing one-lung ventilation during video-assisted lobectomy. There was no significant instability of vital signs, abnormality of perioperative electrocardiography, or malignant arrhythmia. Therefore, we arranged for related management promptly, and the surgery was relatively smooth. This incidental intraoperative hyperkalemia was thought to have resulted from one-lung ventilation and hypercarbia and/or metabolic acidosis. More frequent arterial blood gas analysis and aggressive blood potassium control during video-assisted thoracic surgery should be considered for patients with end-stage renal disease.

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