A case of septic shock after ventricular fibrillation resuscitation due to post-renal acute kidney injury-associated hyperkalemia successfully treated with the combined use of coupled continuous hemodialysis and polymyxin B-immobilized fiber column

Abstract

We report a case of a 71-year-old female with a history of angina pectoris, abdominal aortic aneurysm, right hydronephrosis. 【Present history】The patient was admitted to the emergency room due to loss of consciousness. The next morning, she presented ventricular fibrillation (VF) , hence, she underwent chest compressions and electrical defibrillation. She was admitted to the intensive care unit (ICU) after the return of spontaneous circulation. We diagnosed that the VF was caused by hyperkalemia due to post-renal acute kidney injury (AKI) and initiated high volume high flow (HVHF)-continuous hemodialysis (CHD) . In addition, she was treated for septic shock due to urinary tract infection, the CHD column was changed to AN69ST, and she underwent polymyxin B-immobilized fiber column (PMX) treatment.【Conclusion】This study concluded that a patient with septic shock due to urinary tract infection following VF caused by post-renal AKI-associated hyperkalemia was discharged from the ICU after recovery from shock and renal function using HVHF-CHD and PMX in combination with catecholamine regulation based on detailed circulatory monitoring.