文章基本信息

标题：Can ACE-I Be a Silent Killer While Normal Renal Functions Falsely Secure Us?
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作者：Ahmed Abdelaal Ahmed Mahmoud ; Mark Campbell ; Margarita Blajeva 等
期刊名称：Case Reports in Anesthesiology
印刷版ISSN：2090-6382
出版年度：2018
卷号：2018
DOI：10.1155/2018/1852016
出版社：Hindawi Publishing Corporation
摘要：The current case report represents a warning against serious hyperkalaemia and acidosis induced by ACE-I during surgical stress while normal renal function could deceive the attending anaesthetist. Arterial gas analysis for follow-up of haemoglobin loss accidentally discovered hyperkalaemia and acidosis. Glucose-insulin and furosemide successfully corrected hyperkalaemia after 25 minutes and acidosis after 3 hours. These complications could be explained by a deficient steroid stress response to surgery secondary to suppression by ACE-I. Event analysis and database search found that ACE-I induced aldosterone deficiency aggravated by surgical stress response with an inadequate increase in aldosterone secretion due to angiotensin II deficiency as a sequel of ACE-I leading to defective secretion of H