Frenkel Amit, Hassan Lior, Glick Aviad, Pikovsky Oleg, Boyko Matthew, Binyamin Yair, Novack Victor, Klein Moti
General Intensive Care Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410101, Israel.
Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410101, Israel.
J Clin Med. 2022 May 31;11(11):3117. doi: 10.3390/jcm11113117.
One of the most clinically important effects following the administration of packed cell transfusion (PCT) is hyperkalemia, which can cause severe life-threatening cardiac arrhythmias. This retrospective population-based cohort study included adults hospitalized between January 2007 and December 2019 in a general intensive care unit for 24 h or more, with normal levels of serum potassium on admission. We assessed changes in serum potassium levels after administration of one unit of packed cells and sought to identify clinical parameters that may affect these changes. We applied adjusted linear mixed models to assess changes in serum potassium. The mean increase in serum potassium was 0.09 mEq/L (C.U 0.04−0.14, p-value < 0.001) among the 366 patients who were treated with a single PCT compared to those not treated with PCT. Increased serum potassium levels were also found in patients who required mechanical ventilation, and to a lesser degree in those treated with vasopressors. Hypertension, the occurrence of a cerebrovascular accident, and increased creatinine levels were all associated with reduced serum potassium levels. Due to the small rise in serum potassium levels following PCT, we do not suggest any particular follow-up measures for critically ill patients who receive PCT.
输注浓缩红细胞（PCT）后临床上最重要的影响之一是高钾血症，它可导致严重的危及生命的心律失常。这项基于人群的回顾性队列研究纳入了2007年1月至2019年12月期间在综合重症监护病房住院24小时或更长时间、入院时血清钾水平正常的成年人。我们评估了输注一个单位浓缩红细胞后血清钾水平的变化，并试图确定可能影响这些变化的临床参数。我们应用调整后的线性混合模型来评估血清钾的变化。与未接受PCT治疗的患者相比，在接受单次PCT治疗的366例患者中，血清钾的平均升高为0.09 mEq/L（可信区间0.04 - 0.14，p值<0.001）。需要机械通气的患者血清钾水平也会升高，而使用血管升压药治疗的患者升高程度较小。高血压、脑血管意外的发生以及肌酐水平升高均与血清钾水平降低有关。由于PCT后血清钾水平升高幅度较小，我们不建议对接受PCT的重症患者采取任何特殊的随访措施。
