caa a22 4500 445373237 CHVBK 20180317142954.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00540-011-1220-6 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1220-6 A case of cardiopulmonary arrest caused by laxatives-induced hypermagnesemia in a patient with anorexia nervosa and chronic renal failure [Elektronische Daten] [Hiroomi Tatsumi, Yoshiki Masuda, Hitoshi Imaizumi, Hiromitsu Kuroda, Shin-ichiro Yoshida, Ryoko Kyan, Kyoko Goto, Yasufumi Asai] We report a case of laxatives induced severe hypermagnesemia complicated with cardiopulmonary arrest. A 55-year-old woman, with nephritic syndrome and anorexia nervosa, was later transported to our emergency room (ER) because of oliguria and consciousness disturbance. During transfer to the intensive care unit from the ER, cardiopulmonary arrest suddenly occurred. Cardiopulmonary resuscitation was immediately performed, and spontaneous circulation was restored after 3min. Thereafter, administration of dopamine, norepinephrine, and epinephrine was required to maintain systolic blood pressure at 80mmHg. Arterial blood gas analysis showed severe metabolic alkalosis, and blood biochemical tests revealed hypermagnesemia (serum magnesium concentration, 18.5mg/dl) and renal dysfunction. Continuous infusion of diuretics followed by massive hydration and continuous hemodiafiltration (CHDF) was started. Five days after starting CHDF, magnesium concentration was almost normalized and administration of catecholamine was stopped. It was thought that progression of renal dysfunction that occurred in the patient taking a magnesium product for chronic constipation caused reduction in magnesium excretion ability, resulting in hypermagnesemia-induced cardiopulmonary arrest. To avoid a rebound phenomenon following magnesium flux from cells, continuous blood purification seems to be an effective treatment for symptomatic hypermagnesemia. Japanese Society of Anesthesiologists, 2011 Hypermagnesemia nationallicence Continuous hemodiafiltration nationallicence Blood purification nationallicence Laxatives nationallicence Tatsumi Hiroomi Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut Masuda Yoshiki Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut Imaizumi Hitoshi Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut Kuroda Hiromitsu Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut Yoshida Shin-ichiro Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut Kyan Ryoko Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut Goto Kyoko Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut Asai Yasufumi Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut Journal of Anesthesia Springer Japan 25/6(2011-12-01), 935-938 0913-8668 25:6<935 2011 25 540 https://doi.org/10.1007/s00540-011-1220-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1220-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tatsumi Hiroomi Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Masuda Yoshiki Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Imaizumi Hitoshi Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Kuroda Hiromitsu Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Yoshida Shin-ichiro Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Kyan Ryoko Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Goto Kyoko Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Asai Yasufumi Department of Traumatology and Critical Care Medicine, School of Medicine, Sapporo Medical University, South 1, West 16, Chuo-ku, 060-8543, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/6(2011-12-01), 935-938 0913-8668 25:6<935 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer