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首页> 外文期刊>Journal of Clinical and Diagnostic Research >A Case of BRASH Syndrome, Refractory Acidosis Necessitating Multimodal Approach to Treat it
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A Case of BRASH Syndrome, Refractory Acidosis Necessitating Multimodal Approach to Treat it

机译：一种粗酸综合征，难治性酸中毒需要需要多式化方法来治疗它

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A 69-year-old female patient with hypertension and diabetes mellitus, was brought to Emergency Department in unresponsive state.The initial evaluation revealed that the patient had wide complex junctional bradycardia owing to hyperkalemia; hypoglycaemia, metabolic acidosis.Treatment was started in an attempt to establish definitive airway; correct glucose levels, cardiac membrane stabilisation.Interim, patient had a cardiac arrest and the Return of Spontaneous Circulation (ROSC) was achieved and then stabilised.Later, she was found to have viral hepatitis complicated with ischaemic hepatitis due to urosepsis.Managing a coding patient with severe metabolic acidosis in a resource limited setting is always challenging.Numerous paradoxes including usage of alkali therapy, choice of inotropes, achievement of haemodynamic neutral intubation is extensively studied yet debated.The present case encompasses the difficulties and possible solutions in managing such patient with refractory acidosis, Bradycardia, Renal failure, Atrioventricular (AV) nodal blockers, Shock, Hyperkalemia syndrome (BRASH).
机译：一名69岁的女性患有高血压和糖尿病的女性患者，被带入急诊部门的无响应状态。初步评价显示，由于高钾血症，患者具有宽复杂的交联心动过速;低血症，代谢酸中毒。开始尝试建立定制气道;正确的葡萄糖水平，心膜膜稳定性。患者患有心脏骤停和自发循环返回（ROSC），然后稳定，她被发现，由于尿溶质，她被发现与尿道缺血性肝炎具有复杂的病毒性肝炎。管理者编码资源限制环境中严重代谢酸中毒的患者总是挑战。广泛研究了包括碱治疗的使用，选择鞘型中性插管的毒剂，探讨了血管动力学插管。目前的案例包括管理这些患者的困难和可能的解决方案含有耐火性酸中毒，心动过缓，肾功能衰竭，房室（AV）节点阻滞剂，休克，高钾血症综合征（刺激）。

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