日本延长红细胞制品保存期后，关于大量输血方案期间严重高钾血症潜在事件的警告。
Warning about potential incidents of critical hyperkalemia during massive transfusion protocol after the preservation period of red blood cell products was extended in Japan.
作者信息
Uchida Kenichiro, Mizobata Yasumitsu
机构信息
Department of Traumatology and Critical Care Medicine, Graduate School of Medicine Osaka Metropolitan University Osaka Japan.
出版信息
Acute Med Surg. 2023 Aug 10;10(1):e882. doi: 10.1002/ams2.882. eCollection 2023 Jan-Dec.
BACKGROUND
Recently, the Japanese Red Cross Society approved extension of the preservation period of red blood cell products. Since then, we have already experienced two cases of critical hyperkalemia during massive transfusion protocol (MTP).
CASE PRESENTATION
Case 1, a 24-year-old man was stabbed in his right posterior chest. Although quick hemorrhage control was completed 35 min after arrival, his potassium level increased from 3.5 to 8.9 mEq/L within 40 min. Case 2, a 44-year-old man was transferred to our hospital after a car hit him. We immediately started resuscitation including MTP and opened his abdomen 24 min after arrival. His potassium level increased from 3.5 to 7.8 mEq/L within 38 min.
CONCLUSION
Although several other factors might be causing this rise in potassium, we consider the extended preservation periods of red blood cell products to be one cause of these unexpectedly rapid rises in potassium during MTP.
背景
最近，日本红十字会批准延长红细胞制品的保存期。自那时起，我们在大量输血方案（MTP）期间已经经历了两例严重高钾血症病例。
病例介绍
病例1，一名24岁男性右后胸部被刺伤。尽管到达后35分钟内迅速控制了出血，但他的血钾水平在40分钟内从3.5 mEq/L升至8.9 mEq/L。病例2，一名44岁男性在被汽车撞击后被转送至我院。我们立即开始包括MTP在内的复苏，并在到达后24分钟打开他的腹部。他的血钾水平在38分钟内从3.5 mEq/L升至7.8 mEq/L。
结论
尽管可能有其他几个因素导致血钾升高，但我们认为红细胞制品保存期的延长是MTP期间血钾意外快速升高的原因之一。
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