Urinary Tract Infection Causing Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report and a Brief Review of the Literature.
| Autor: | Pata R; Pulmonary and Critical Care Medicine, One Brooklyn Health, New York, USA.; Pulmonary and Critical Care Medicine, University of Cincinnati Medical Center, Cincinatti, USA., Lutaya I; Medicine, American University of Antigua, New York, USA., Mefford M; Medicine, American University of Antigua, New York, USA., Arora A; Medicine, Interfaith Medical Center, New York, USA., Nway N; Internal Medicine, Interfaith Medical Center, New York, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2022 Aug 03; Vol. 14 (8), pp. e27641. Date of Electronic Publication: 2022 Aug 03 (Print Publication: 2022). |
| DOI: | 10.7759/cureus.27641 |
| Abstrakt: | Bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia (BRASH) syndrome commonly occurs in the elderly population with compromised renal function and a history of taking AV nodal blocking agents on a regular basis. Hypovolemia and worsening of renal function are considered to be the major risk factors. BRASH syndrome should be differentiated from pure intoxication with AV nodal blocking agents, as the therapeutic goals of these conditions are different from each other. It encompasses a vicious cycle of bradycardia and decreased cardiac output leading to organ dysfunction including renal failure with hyperkalemia, further augmenting bradycardia. It is usually associated with high morbidity and mortality. Typically, the treatment involves increasing renal blood flow by augmenting cardiac output using catecholamine infusion. Very rarely, interventions such as intralipid emulsion and continuous renal replacement therapy (CRRT) may be required on a case-to-case basis. Promptly recognizing the symptoms of BRASH syndrome can help to avoid diagnostic delays and reduce mortality rates. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Pata et al.) |
| Databáze: | MEDLINE |
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