Department of Anesthesiology and Reanimation, Vocational School of Health Sciences, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
Department of Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
J Card Surg. 2022 Mar;37(3):535-541. doi: 10.1111/jocs.16158. Epub 2021 Nov 24.
Transfusion-associated hyperpotassemia is a serious complication of packed red blood cell (PRBC) transfusion after congenital cardiac surgery. Our study aimed to identify risk factors and potential preventive measures of transfusion-associated hyperpotassemia in neonates and infants after congenital cardiac surgery.
Pediatric patients who underwent congenital cardiac surgery and need transfusion were enrolled in this prospective study. The potassium concentration of PRBC was checked from the sample taken from the segment. The volume of transfusion, age of PRBC, potassium concentration of unit were recorded. The estimated increment of potassium level in patients after PRBC transfusion was calculated.
Seventy-four individual patients, 95 distinct transfusions, 112 blood products were evaluated. The mean age of the blood unit was 3.8 ± 1.4 days. The mean potassium concentration in the PRBCs was 9.9 ± 2.4 mmol/L. A weak correlation was observed between the potassium value of the PRBC and the age of PRBC (p = 0.049, r = 0.2, y = 0.24 × x + -0.68). There was a weak correlation between the potassium value of PRBCs and the age of the unit (p < 0.001, r = 0.37, y = 2.8 × x + -3.6).
Before transfusion, even PRBC is fresh, measuring the potassium level of PRBC and the potassium that will be given to the pediatric patient with transfusion can prevent transfusion-related hyperpotassemia and related complications. Otherwise, high potassium levels, which may be overlooked despite being fresh, may cause serious complications, even cardiac arrest, especially in neonates and infants.
输血相关性高钾血症是先天性心脏手术后输注浓缩红细胞（PRBC）的严重并发症。本研究旨在确定先天性心脏手术后新生儿和婴儿输血相关性高钾血症的危险因素和潜在预防措施。
本前瞻性研究纳入了接受先天性心脏手术且需要输血的儿科患者。从取自片段的样本中检查 PRBC 的钾浓度。记录 PRBC 的输注量、PRBC 的年龄、单位的钾浓度。计算患者 PRBC 输血后钾水平的估计增量。
评估了 74 名个体患者的 95 次不同输血，共 112 个血制品。血单位的平均年龄为 3.8±1.4 天。PRBC 的平均钾浓度为 9.9±2.4mmol/L。PRBC 的钾值与 PRBC 的年龄之间存在弱相关性（p=0.049，r=0.2，y=0.24×x+-0.68）。PRBC 的钾值与单位的年龄之间存在弱相关性（p<0.001，r=0.37，y=2.8×x+-3.6）。
在输血前，即使 PRBC 是新鲜的，测量 PRBC 的钾水平和将给予输血的儿科患者的钾量也可以预防输血相关性高钾血症和相关并发症。否则，尽管是新鲜的，但可能会忽略高钾血症，这可能导致严重的并发症，甚至心脏骤停，尤其是在新生儿和婴儿中。
