{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:23:51Z","timestamp":1787847831924,"version":"build-2784847793"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>BRASH syndrome is a syndrome characterized by bradycardia, renal failure, usage of atrioventricular (AV) nodal blocker, shock, and hyperkalemia (BRASH). It is more common among patients with multiple comorbidities such as cardiac disease, kidney dysfunction, and hypertension requiring AV nodal blockers. Cardiac conduction abnormalities are frequently caused by severe hyperkalemia. However, it may also occur in mild-to-moderate hyperkalemia with concomitant use of AV nodal blockers due to the synergistic effects between these two factors in the presence of renal insufficiency. It is essential for the physician to identify BRASH syndrome as the treatment may differ from standard advanced cardiovascular life support (ACLS) protocol. We report the two cases of patient who presented with BRASH syndrome who failed to respond to standard ACLS protocol.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/2452-2473.309138","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T19:17:13Z","timestamp":1613071033000},"page":"86-89","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["Bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia"],"prefix":"10.4103","volume":"21","author":[{"given":"Chui King","family":"Wong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Johar","family":"Jaafar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-9-20240909","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ancard.2005.10.001","article-title":"Sinus arrest and moderate hyperkalemia","volume":"55","author":"Bonvini","year":"2006","journal-title":"Ann Cardiol Angeiol (Paris"},{"key":"R3-9-20240909","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/0002-9343(86)90688-1","article-title":"Hypotension and sinus arrest with exercise-induced hyperkalemia and combined verapamil\/propranolol therapy","volume":"80","author":"Lee","year":"1986","journal-title":"Am J Med"},{"key":"R4-9-20240909","doi-asserted-by":"crossref","first-page":"329","DOI":"10.17576\/MH.2017.1202.17","article-title":"Correlation of iatrogenic mild hyperkalaemia and bradyarrhythmia: A problem of polypharmacy in elderly","volume":"12","author":"Ahmad","year":"2017","journal-title":"Med Health"},{"key":"R5-9-20240909","first-page":"e7816","article-title":"Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome as a presentation of coronavirus disease 2019","volume":"12","author":"Prabhu","year":"2020","journal-title":"Cureus"},{"key":"R6-9-20240909","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1046\/j.1525-139X.2001.00087.x","article-title":"Hyperkalemia in dialysis patients","volume":"14","author":"Ahmed","year":"2001","journal-title":"Semin Dial"},{"key":"R7-9-20240909","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/0736-4679(86)90174-5","article-title":"Hyperkalemia: ECG manifestations and clinical considerations","volume":"4","author":"Dittrich","year":"1986","journal-title":"J Emerg Med"},{"key":"R8-9-20240909","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1111\/j.1365-2710.2012.01352.x","article-title":"Junctional bradycardia with verapamil in renal failure\u2013care required even with mild hyperkalaemia","volume":"37","author":"Hegazi","year":"2012","journal-title":"J Clin Pharm Ther"},{"key":"R9-9-20240909","first-page":"A3467","article-title":"Bradycardia, renal failure, AV-nodal blockers, shock, and hyperkalemia (BRASH) A new clinical syndrome. B47. Critical Care Case Reports: Cardiovascular Diseases and Echocardiography","volume":"197","author":"Golchin","year":"2018","journal-title":"Am J Respir Crit Care Med"}],"container-title":["Turkish Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/2452-2473.309138","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:40:09Z","timestamp":1787845209000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/2452-2473.309138"}},"subtitle":["An important syndrome to recognize"],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/2452-2473.309138","relation":{},"ISSN":["2452-2473"],"issn-type":[{"value":"2452-2473","type":"print"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}