Severe Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome Successfully Managed With Transvenous Pacing and Continuous Renal Replacement Therapy
Disha C Shetty, Sankalp Acharya, Hans Jesper F Del Mundo, Raghav Gera, Hardikkumar Bhanderi · 2026
Read Severe Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome Successfully Managed With Transvenous Pacing and Continuous Renal Replacement Therapy by Disha C Shetty, Sankalp Acharya, Hans Jesper F Del Mundo, Raghav Gera, Hardikkumar Bhanderi (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/pmc-13333146.txt.
Description
Disha C Shetty and colleagues report a 2026 case of BRASH syndrome managed with transvenous pacing and continuous renal replacement therapy. BRASH stands for bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia, a life-threatening cycle in which high potassium and nodal-blocking drugs together drive profound slow heart rate and unstable circulation. The patient was a 71-year-old man with stage IIIB chronic kidney disease, heart failure, and coronary artery disease after bypass surgery.
He took carvedilol, losartan, and torsemide, and was brought from a rehabilitation facility after fainting and unresponsiveness. He had lately been in hospital with multifocal pneumonia and a respiratory syncytial virus infection, plus suspected volume loss and ongoing nodal blockade feeding the syndrome. He arrived in respiratory distress, profound shock, and bradycardia at thirty beats per minute. The case shows how pacing plus continuous renal support can break the BRASH cycle.
Catalog record
| CREATOR | Disha C Shetty, Sankalp Acharya, Hans Jesper F Del Mundo, Raghav Gera, Hardikkumar Bhanderi |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 16 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |