Fukuoka Y, Ishiyama T, Oguchi T, Nonaka A, Kumazawa T
Department of Anesthesiology, Yamanashi Medical University.
Masui. 1999 Feb;48(2):192-4.
A 70-yr-old woman was scheduled for hepatectomy and colectomy. We gave general anesthesia with N2O-O2-Isoflurane and continuous epidural block. About 4.5 hours after the start of the operation, 8 units of irradiated RBC-MAP were transfused. Then elevated T waves were noted and serum potassium was increased to 5.4 mmol.l-1. The transfusion of RBC-MAP was stopped and calcium gluconate was administered immediately. Then serum potassium decreased to 4.3 mmol.l-1 and ECG returned to normal. During the operation, 10 units of irradiated RBC-MAP were transfused and 8 units of them had been stored more than 1 week after the irradiation. We suspect that hyperkalemia was induced by high concentration of potassium in RBC-MAP. Irradiation of blood products is an effective way to prevent post-transfusion graft versus host disease. However, the increase in potassium is greater in the irradiated than nonirradiated RBC-MAP. We must pay attention to the high concentration of potassium in th eplasma of RBC-MAP stored after irradiation.
一名70岁女性计划接受肝切除术和结肠切除术。我们采用氧化亚氮-氧气-异氟烷全身麻醉和连续硬膜外阻滞。手术开始约4.5小时后,输注了8单位辐照红细胞-保养液。随后发现T波升高,血清钾升至5.4 mmol/L。停止输注红细胞-保养液,并立即给予葡萄糖酸钙。随后血清钾降至4.3 mmol/L,心电图恢复正常。手术期间,输注了10单位辐照红细胞-保养液,其中8单位在辐照后储存超过1周。我们怀疑高钾血症是由红细胞-保养液中高浓度钾引起的。血液制品辐照是预防输血后移植物抗宿主病的有效方法。然而,辐照红细胞-保养液比未辐照的红细胞-保养液钾含量增加更多。我们必须注意辐照后储存的红细胞-保养液血浆中钾的高浓度。