The Safety of Glucagon use during ERCP in Diabetic Patients with Renal Insufficiency: A Case Discussion and Review of Literature

Authors

  • Lisa Erlinger, PhD, CRNA Midwestern University Wickenburg Community Hospital University of Missouri-Columbia
  • Terri Monk, MD, MS University of Missouri-Columbia
  • Steven McAfee, MD University of Missouri-Columbia

DOI:

https://doi.org/10.18776/50y5r380

Keywords:

Endoscopic retrograde cholangiopancreatography, , Glucagon, ERCP, Diabetes, Diabetic, Renal Insufficiency, Renal insufficiency, Hyperkalemia

Abstract

This is a case report with the use of glucagon during ERCP which resulted in Hyperkalemia.  A 45 year old male, ASA 3, with Type 1 diabetes mellitus, hypertension, and chronic kidney disease underwent ERCP with general anesthesia for evaluation of a bile duct stricture.  After administration of 0.75 mg glucagon (0.25 mg doses over an hour) tall, peaked T-waves were noted on the ECG. Labs were drawn and potassium was 6.6 mEq/L and glucose was 393 mg/dL. Intravenous calcium chloride, 1000 mg, was titrated.  Repeat potassium was 6.1mEq/L and glucose 568 mg/dL.  The remainder of the procedure was uneventful and postoperative potassium was 5.2 mEq/dL.  

Author Biographies

  • Lisa Erlinger, PhD, CRNA, Midwestern University Wickenburg Community Hospital University of Missouri-Columbia

    Assistant Professor MidWestern University-St. Louis University, Director of Surgical and Anesthesia Services Wickenburg Community Hospital

  • Terri Monk, MD, MS, University of Missouri-Columbia

    Professor of Clinical Anesthesiology University of Missouri

  • Steven McAfee, MD, University of Missouri-Columbia

    Anesthesiologist University of Missouri-Columbia

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Published

2018-11-07

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Section

Articles