The successful use of extracorporeal membrane oxygenation combined with continuous renal replacement therapy for a cardiac arrest patient with refractory hypokalemia and diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is a common clinically severe disease, with an incidence of 24.9/1,000 among diabetes patients, and approximately 180,000 people in the United States suffer from DKA every year. The reported mortality rate associated with DKA ranges from 0.65% to 3.30%, and is commonly caused by electrolyte imbalances, especially hypokalemia and hyperkalemia. eports indicated that hypokalemia was observed in 5.6% of patients with DKA before therapy, 7] Extracorporeal membrane oxygenation (ECMO) can be considered for patients whose cause of cardiac arrest is potentially reversible. When DKA patients develop fatal dysrhythmia or even cardiac arrest induced by severe hypokalemia, ECMO could maintain circulation and provide time to correct electrolyte imbalances, while continuous renal replacement therapy (CRRT) could be used to restore homeostasis. e report a case of a young male with DKA complicated with refractory hypokalemia, malignant arrhythmia and cardiac arrest. After failing to reverse his hypokalemia by providing potassium chloride intravenously in a short time and conventional organ support therapy, veno-arterial (VA)-ECMO combined with CRRT was performed.