[Metabolic disorders caused by blood transfusions].

Preserved stored blood undergoes metabolic changes depending on the duration of storage. These metabolic changes include a deprivation of 2,3-diphosphoglycerate (2,3-DPG), acidosis and hyperkalemia. The preservative contains citrate as an anticoagulant which binds the ionised serum calcium. 2,3-DPG depleted erythrocytes show a clearly elevated oxygen affinity. Following massive transfusion, these changes can also occur in the recipient. Under these conditions, patients with coronary artery disease show impaired heart function. Prejudicial changes concerning other vital systems have not yet been definitely proved. Acidosis, hypocalcemia and hyperkalemia can take place under massive transfusion. Normally the body's own compensatory mechanisms ensure sufficient recompensation; however, under hypothermia or shock these mechanisms can be impaired. Disturbances of the electrolyte and acid base system are safely detected by ECG and regularly performed acid base analysis.