Martin David P, Gomez Daniel, Tobias Joseph D, Schechter William, Cusi Carlos, Michler Robert
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Ohio State University, Columbus, OH 43205, USA.
World J Pediatr Congenit Heart Surg. 2013 Apr;4(2):197-200. doi: 10.1177/2150135112467213.
Hyperkalemia is considered a medical emergency as it can result in severe disturbances in cardiac rhythm and death. Although many causes of hyperkalemia exist, exogenous red blood cell transfusions are being recognized as the primary perioperative etiology. The authors report a case of severe intraoperative hyperkalemia associated with the use of allogeneic blood products (packed red blood cells), during a surgical mission to a developing country. The patient was undergoing repeat mitral valve replacement with cardiopulmonary bypass (CPB) and developed significant hyperkalemia with a serum potassium value of 9.9 mEq/L. Successful intraoperative therapies were instituted with a gradual reduction in the serum potassium value to 4.8 mEq, which allowed the patient to be weaned from CPB. The authors review the etiology of hyperkalemia in children including its relationship with allogeneic red blood cell transfusions and treatment modalities including specific therapies which can be instituted during CPB.
高钾血症被视为一种医疗急症，因为它可导致严重的心律紊乱甚至死亡。尽管高钾血症存在多种病因，但外源性红细胞输血正被认为是围手术期的主要病因。作者报告了一例在前往发展中国家的外科手术任务中，与使用同种异体血制品（浓缩红细胞）相关的严重术中高钾血症病例。该患者正在接受体外循环（CPB）下的二尖瓣置换术，出现了严重的高钾血症，血清钾值达9.9 mEq/L。术中采取了成功的治疗措施，血清钾值逐渐降至4.8 mEq，使患者得以脱离体外循环。作者回顾了儿童高钾血症的病因，包括其与同种异体红细胞输血的关系，以及治疗方式，包括在体外循环期间可采取的特定治疗方法。
