Acute medicine & surgery
Influenza-Induced Rhabdomyolysis Leading to Hyperkalemic Cardiac Arrest Managed With Venoarterial Extracorporeal Membrane Oxygenation: A Case Report
Von Miyake Y, Abe T, Tokunaga K und 8 weiteren.
Inhalt auf Englisch
Abstract
Background
Influenza-induced rhabdomyolysis is an uncommon but serious complication that can cause life-threatening hyperkalemia. The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for hyperkalemic cardiac arrest has rarely been described.
Case presentation
A 48-year-old woman with influenza A developed severe rhabdomyolysis (creatine kinase: 255,240 U/L) and progressive hyperkalemia despite improved renal function and continuous renal replacement therapy. On hospital day 3, the patient experienced a hyperkalemic cardiac arrest and VA-ECMO was initiated after 29 min of low-flow time. Treatment for hyperkalemia was continued, and cardiac function gradually recovered, allowing the removal of ECMO on day 8. However, she later developed hemorrhagic complications related to mechanical circulatory support and died on hospital day 89.