{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:58:30Z","timestamp":1740135510813,"version":"3.37.3"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This case demonstrates the severe electrolyte derangements that may present after a common therapy such as a bowel preparation for an outpatient procedure and the rare yet potential detrimental outcomes of those abnormalities. It also highlights the implications of long QT syndrome regarding pharmacology and treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present a case of 48 year-old female with severe electrolyte derangements and long QT syndrome (LQTS) leading to Torsades de Pointes (TdP), pulseless ventricular fibrillation, and unsynchronized defibrillation in the post anesthesia care unit (PACU) after uneventful upper and lower endoscopy. This led to an unanticipated intensive care unit admission for aggressive electrolyte repletion, cardiology consultation, and implantable cardioverter defibrillator (ICD) placement.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This is a rare presentation after an outpatient procedure that would have had a detrimental outcome if not promptly diagnosed and treated appropriately. Therefore, we aim to provide further insight into the diagnosis and treatment of severe hypokalemia and long QT syndrome resulting in Torsades de Pointes and ventricular fibrillation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-021-01457-9","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T12:09:43Z","timestamp":1638360583000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Torsades de pointes in the PACU after outpatient endoscopy: a case report"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2587-1270","authenticated-orcid":false,"given":"Andrew","family":"Schaar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Patzkowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,1]]},"reference":[{"issue":"4","key":"1457_CR1","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1097\/01.anes.0000281893.39781.64","volume":"107","author":"GA Nuttall","year":"2007","unstructured":"Nuttall GA, Eckerman KM, Jacob KA, Pawlaski EM, Wigersma SK, Marienau ME, et al. Does low-dose droperidol administration increase the risk of drug-induced QT prolongation and torsade de pointes in the general surgical population? Anesthesiology. 2007;107(4):531\u20136. https:\/\/doi.org\/10.1097\/01.anes.0000281893.39781.64 PMID: 17893447.","journal-title":"Anesthesiology."},{"unstructured":"Drugs to be Avoided by Congenital Long QT Patients (3 May 2021); Retrieved from: https:\/\/crediblemeds.org\/index.php\/tools\/pdfdownload?f=dta_en.","key":"1457_CR2"},{"issue":"9","key":"1457_CR3","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.1113\/JP270526","volume":"594","author":"DM Roden","year":"2016","unstructured":"Roden DM. Predicting drug-induced QT prolongation and torsades de pointes. J Physiol. 2016;594(9):2459\u201368. https:\/\/doi.org\/10.1113\/JP270526 Epub 2016 Jan 18. PMID: 26660066; PMCID: PMC4850203.","journal-title":"J Physiol"},{"issue":"1","key":"1457_CR4","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1152\/physrev.00008.2016","volume":"97","author":"MS Bohnen","year":"2017","unstructured":"Bohnen MS, Peng G, Robey SH, Terrenoire C, Iyer V, Sampson KJ, et al. Molecular pathophysiology of congenital long QT syndrome. Physiol Rev. 2017;97(1):89\u2013134. https:\/\/doi.org\/10.1152\/physrev.00008.2016 PMID: 27807201; PMCID: PMC5539372.","journal-title":"Physiol Rev"},{"unstructured":"Clinical Factors Associated with Prolonged QTc and\/or TdP. Retrieved from: https:\/\/crediblemeds.org\/ndfa_list","key":"1457_CR5"},{"key":"1457_CR6","doi-asserted-by":"publisher","first-page":"3845108","DOI":"10.1155\/2016\/3845108","volume":"2016","author":"K Mouyis","year":"2016","unstructured":"Mouyis K, Okonko D, Missouris CG. Idiopathic intractable Diarrhoea leading to torsade de pointes. Case Rep Cardiol. 2016;2016:3845108. https:\/\/doi.org\/10.1155\/2016\/3845108.","journal-title":"Case Rep Cardiol"},{"issue":"12","key":"1457_CR7","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1185\/03007995.2013.840568","volume":"29","author":"KE Trinkley","year":"2013","unstructured":"Trinkley KE, Page RL 2nd, Lien H, Yamanouye K, Tisdale JE. QT interval prolongation and the risk of torsades de pointes: essentials for clinicians. Curr Med Res Opin. 2013;29(12):1719\u201326. https:\/\/doi.org\/10.1185\/03007995.2013.840568 Epub 2013 Sep 23. PMID: 24020938.","journal-title":"Curr Med Res Opin"},{"key":"1457_CR8","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.925602","volume":"21","author":"M Coleman","year":"2020","unstructured":"Coleman M, Imundo JR, Cortez D, Cohen MH, Dhar P, Dalal PG. Torsades de pointes during Myringotomy in a child with congenital long QT syndrome: a case report. Am J Case Rep. 2020;21:e925602. https:\/\/doi.org\/10.12659\/AJCR.925602 PMID: 33056945; PMCID: PMC7571281.","journal-title":"Am J Case Rep"},{"issue":"3","key":"1457_CR9","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1111\/bcp.12726","volume":"81","author":"SH Thomas","year":"2016","unstructured":"Thomas SH, Behr ER. Pharmacological treatment of acquired QT prolongation and torsades de pointes. Br J Clin Pharmacol. 2016;81(3):420\u20137. https:\/\/doi.org\/10.1111\/bcp.12726 Epub 2015 Oct 26. PMID: 26183037; PMCID: PMC4767204.","journal-title":"Br J Clin Pharmacol"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-021-01457-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-021-01457-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-021-01457-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T12:10:42Z","timestamp":1638360642000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-021-01457-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1457"],"URL":"https:\/\/doi.org\/10.1186\/s12871-021-01457-9","relation":{},"ISSN":["1471-2253"],"issn-type":[{"type":"electronic","value":"1471-2253"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"14 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written consent to publish this information was obtained from the patient discussed in the case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"302"}}