Introduction: Patients admitted to intensive care units (ICU) often have multiple co-morbidities and are on several drugs. These medications may have drug interactions that may complicate the disease course of the patient.
Case description: Here, we describe a patient with chronic kidney disease on atrioventricular (AV) nodal-blocking drugs who developed refractory bradycardia and shock, managed with emergency dialysis.
Conclusions: A new clinical entity of bradycardia, renal failure, AV nodal blocking drugs, shock, and hyperkalemia (BRASH) syndrome has been described in which patients with underlying renal dysfunction may develop bradycardia, hyperkalemia, and shock when prescribed AV nodal blocking agents. Bradycardia and shock may be life-threatening and refractory to standard therapy. Hence, physicians should be aware of the underlying pathophysiology and therapeutic measures required to manage BRASH syndrome in order to improve patient outcomes.
Farkas J. PulmCrit–BRASH Syndrome: Bradycardia, Renal Failure, Av Blocker, Shock, Hyperkalemia. Available from: https://emcrit.org/pulmcrit/brash-syndrome-bradycardia-renal-failure-av-blocker-shock-hyperkalemia/. Last assessed on 16 Sept 2022.
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