Driscoll D F, Bistrian B R, Jenkins R L, Randall S, Dzik W H, Gerson B, Blackburn G L
Department of Pharmacy, New England Deaconess Hospital, Boston, MA.
Crit Care Med. 1987 Oct;15(10):905-8. doi: 10.1097/00003246-198710000-00002.
Five patients undergoing orthotopic liver transplantation were investigated for changes in acid-base homeostasis secondary to large volume transfusions. All patients developed a transient acidemia during the operative period, followed by alkalemia which persisted into the early postoperative period. The patients received an estimated mean of 750 mEq of citrate, which appeared to cause metabolic alkalosis. The biochemical basis underlying the regulation of citrate metabolism that may have led to the timing, extent, and duration of the subsequent metabolic alkalosis is presented. Finally, the time course for the development of metabolic alkalosis may be a potentially sensitive indicator of early allograft function.
