Clinical Case Scenario
A 45-year-old male undergoing treatment for diffuse large B-cell lymphoma at a day care center develops oliguria 24 hours post-chemotherapy. Despite aggressive hydration, rasburicase, and allopurinol, the patient remains oliguric. Laboratory results reveal a serum potassium of 7.2 mEq/L, serum phosphate of 8.5 mg/dL, serum calcium of 6.0 mg/dL, serum uric acid of 20 mg/dL, and a creatinine level of 4.5 mg/dL. A critical care referral is made after the patient exhibits stridor and generalized muscle cramps. The 12-lead ECG shows a QTc interval of 550 msec.
What is the next best step in management?
