A case of severe hyperkalaemia and compartment syndrome due to rhabdomyolysis after drugs abuse

• Published in: Resuscitation Vol. 54; no. 1; pp. 103 - 105
• Main Authors: Ochoa-Gómez, J., Villar-Arias, A., Aresti, Irune, Marco-Aguilar, Pedro
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01-07-2002; Elsevier
• Subjects: Adult; Biological and medical sciences; Cardiac arrest; Cardiopulmonary resuscitation; Compartment syndrome; Compartment Syndromes - diagnosis; Compartment Syndromes - etiology; Drug addictions; Drug overdose; Humans; Hyperkalaemia; Hyperkalemia - diagnosis; Hyperkalemia - etiology; Male; Medical sciences; Rhabdomyolysis; Rhabdomyolysis - diagnosis; Rhabdomyolysis - etiology; Substance-Related Disorders - complications; Toxicology; Hyperkalaemia; Rhabdomyolysis; Drug overdose; Compartment syndrome; Cardiopulmonary resuscitation; Cardiac arrest; Drug addiction; Intravenous administration; Arrhythmia; Cardiovascular disease; Alcohol; Inorganic element; Trauma; Excitability disorder; Arterial disease; Vascular disease; Case study; Pupil; Striated muscle disease; Emergency department; Heart disease; Surgery; Electrocardiography; Complication; Asystole; Resuscitation
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/S0300-9572(02)00051-5

Severe hyperkalaemia is one of the complications of the non-traumatic rhabdomyolysis, which have been related to drug abuse, alcohol, etc. We report on a case of bilateral tibial compartment syndrome, severe hyperkalaemia and rhabdomyolysis after drug abuse. A 35-year-old male intravenous drug user was admitted to the emergency department after being found unconscious in his cell of the prison. Physical examination at emergency department revealed no abnormalities except constricted pupils. Two hours after admission a wide QRS was observed in the electrocardiography and he developed asystole. Cardiopulmonary resuscitation was performed and transcutaneous pacing was applied at the beginning of cardiac arrest (150 mAmp and stimulation frequency 80 beats/min). At the moment of cardiac arrest, laboratory test showed potassium 9.2 mmol/l. Return of spontaneous circulation occurred in 21 min, and he was admitted to the Intensive Care Unit. Thirty-six hours after admission a compartment syndrome of both lower legs was suspected because of oedema with peripheral pulses. Rhabdomyolysis has been reported after drug abuse. There is severe hyperkalaemia which should be identified and treated. A more rare complication of rhabdomyolysis is the compartment syndrome, a surgical emergency, which requires immediate fasciotomy to prevent serious complications.