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VOLUME 1 , ISSUE 2 ( May-August, 2023 ) > List of Articles

CASE REPORT

A Case Report of BRASH Syndrome (Bradycardia, Renal Failure, AV Blockade, Shock, and Hyperkalaemia)

Rajesh Adangi, Manjith Kothapalli Sekhar, Harish Telu

Keywords : AV blockade, Bradycardia, Brash syndrome, Case report, Hyperkalaemia, Renal failure, Shock

Citation Information : Adangi R, Sekhar MK, Telu H. A Case Report of BRASH Syndrome (Bradycardia, Renal Failure, AV Blockade, Shock, and Hyperkalaemia). 2023; 1 (2):56-58.

DOI: 10.5005/njem-11015-0015

License: CC BY-NC 4.0

Published Online: 05-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

This case report discusses BRASH syndrome, characterized by bradycardia, renal failure, AV blockade, shock, and hyperkalaemia. It typically arises from the interaction between high potassium levels and drugs that affect the AV node, often triggered by factors like low blood volume or medications promoting hyperkalaemia or kidney damage. Patients with BRASH syndrome display various symptoms and are often critically ill, but early recognition can lead to effective treatment and better outcomes.


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  1. Farkas JD, Long B, Koyfman A, et al. BRASH Syndrome: Bradycardia, renal failure, AV blockade, shock, and hyperkalemia. J Emerg Med 2020;59(2):216–223. DOI: 10.1016/j.jemermed.2020.05.001.
  2. Simmons T, Blazar E. Synergistic bradycardia from beta blockers, hyperkalemia, and renal failure. J Emerg Med 2019;57(2): e41–e44. DOI: 10.1016/j.jemermed.2019.03.039.
  3. Sohal S. Syndrome of bradycardia, renal failure, atrioventricular nodal blockers, shock, and hyperkalemia (BRASH syndrome): A new clinical entity? Chest 2019;156(suppl):A74. DOI: https://doi.org/10.1016/j.chest.2019.08.168.
  4. O'Malley CM, Frumento RJ, Hardy MA, et al. A randomized, double-blind comparison of lactated Ringer's solution and 0.9% NaCl during renal transplantation. Anesth Analg 2005;100(5):1518–1524. DOI: 10.1213/01.ANE.0000150939.28904.81.
  5. Moussavi K, Fitter S, Gabrielson SW, et al. Management of hyperkalemia with insulin and glucose: Pearls for the emergency clinician. J Emerg Med 2019;57(1):36–42. DOI: 10.1016/j.jemermed.2019.03.043.
  6. Hegazi MO, Aldabie G, Al-Mutairi S, et al. Junctional bradycardia with verapamil in renal failure–care required even with mild hyperkalaemia. J Clin Pharm Ther 2012;37(6):726–728. DOI: 10.1111/j.1365-2710.2012.01352.x.
  7. Letavernier E, Couzi L, Delmas Y, et al. Verapamil and mild hyperkalemia in hemodialysis patients: A potentially hazardous association. Hemodial Int 2006;10(2):170–172. DOI: https://doi.org/10.1111/j.1542-4758.2006.00090.x.
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