Does Heparin Cause Hyperkalemia

Twenty minutes later, the repeat results were back. It wasn't an error. The potassium was 6.4 mmol/L. Mr. Henderson’s heart rhythm was beginning to waver, the PR interval lengthening.

"Start Calcium Gluconate, ten units," Aris barked at the nurse, a veteran named Sarah. "And give the insulin-and-dextrose protocol. We need to drive that potassium into the cells before his heart stops." does heparin cause hyperkalemia

Aris felt a cold prickle of anxiety. He had corrected the pH, he had stopped the meds. What was he missing? He pulled up the medication administration record (MAR), scanning for anything—succinylcholine, digoxin, NSAIDs. Twenty minutes later, the repeat results were back

They worked through the night. Aris watched the monitor like a hawk, his coffee going cold on the desk. Slowly, agonizingly slowly, the T-waves began to flatten. The heart rate stabilized. "And give the insulin-and-dextrose protocol

Sarah moved with practiced efficiency, but frowned as she hung the IV bag. "Doctor, I don’t see why he’s spiking. We stopped his ACE inhibitor this morning. He hasn't had any potassium in his IV fluids. His kidneys are working fine."

Sarah walked over to the desk, handing Aris a fresh cup of coffee. "You called it. The pharmacy double-checked. Unfractionated heparin can cause hyperkalemia in about 7-8% of patients, usually those with diabetes or kidney issues, but sometimes... just sometimes."

Aris took the coffee, his hands finally steady. "The problem with standard protocols," he murmured, watching the sunrise peek through the ICU blinds, "is that sometimes the standard poison looks exactly like the cure."