Highlights the risk of hyperkalemic cardiac arrest after cardiopulmonary bypass in children with unsuspected Duchenne muscular dystrophy and the importance of preoperative screening.
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Alerts clinicians to hyperkalemic arrest risk in unsuspected pediatric DMD post-bypass; case report leaves screening value unproven.
In Brief Adverse reactions to volatile anesthetics and depolarizing muscle relaxants can occur in patients with Duchenne muscular dystrophy (DMD) resulting in acute rhabdomyolysis and hyperkalemia. We report a case of hyperkalemic cardiac arrest after cardiac surgery using cardiopulmonary bypass in a child with unsuspected DMD. Early diagnosis and management of hyperkalemia resulted in a successful outcome. Genetic testing confirmed the diagnosis of DMD. We recommend a thorough preoperative investigation, including creatine kinase estimation, in children with a history of unexplained motor delay. IMPLICATIONS: A child with unsuspected Duchenne muscular dystrophy developed hyperkalemic cardiac arrest after cardiac surgery using cardiopulmonary bypass. Prompt intervention, including recognition and management of hyperkalemia, resulted in a successful outcome.
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Nathan et al. (2005) studied this question.
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