Succinylcholine-induced hyperkalemia is reported, but is still used in rapid sequence induction. In our case a 44 year-old man with septic shock was mechanically ventilated for 13 days, extubated but because of respiratory insufficiency reintubated. During induction an increase in p-potassium (4.2-11.7 mmol/l) caused ventricular fibrillation. Immobilization/infection cause an up-regulation and change in acetylcholine receptors is probably the reason for the extensive hyperkalemia and death. Caution in using succinylcholine is recommended and using rocuronium as an alternative is discussed.
Ugeskrift for Laeger, 2011, Vol 173, Issue 43, p. 2704-5