大量输血方案后发生尖端扭转型室速：突出输血制品后电解质紊乱的病例
Torsades de Pointes Following Massive Transfusion Protocol: Case Highlighting Electrolyte Disturbances After Blood Product Administration.
作者信息
Khan Mahir, Kabir Nawshin, Mody Shefali, Essop Tasiyah, Urciuoli David
机构信息
Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
出版信息
JACC Case Rep. 2025 Aug 27;30(25):104795. doi: 10.1016/j.jaccas.2025.104795.
BACKGROUND
Torsades de Pointes (TdP) is caused by QT-prolonging medications, electrolyte disturbances, structural heart disease, congenital long-QT syndromes, female gender, and age. If left untreated, it can lead to cardiac arrest and death.
CASE SUMMARY
In this report, we highlight a case of TdP after the transfusion of massive blood products leading to electrolyte disturbances causing QT prolongation.
DISCUSSION
This case underscores the need for careful electrolyte monitoring and QT assessment in patients receiving large-volume blood products, and refinement of guidelines regarding electrolyte monitoring and repletion posttransfusion.
TAKE-HOME MESSAGES: TdP is an often-fatal arrhythmia that can be caused by QT prolongation secondary to electrolyte disturbances. Massive blood transfusions can predispose patients to electrolyte depletion, QT prolongation, and TdP. Further refinement of guidelines regarding electrolyte monitoring and QT interval assessment is warranted to prevent complications such as TdP.
背景
尖端扭转型室速（TdP）由延长QT间期的药物、电解质紊乱、结构性心脏病、先天性长QT综合征、女性性别和年龄引起。若不治疗，可导致心脏骤停和死亡。
病例摘要
在本报告中，我们重点介绍了1例在输注大量血液制品后发生TdP的病例，大量输血导致电解质紊乱，进而引起QT间期延长。
讨论
该病例强调了对接受大量血液制品的患者进行仔细的电解质监测和QT评估的必要性，以及完善输血后电解质监测和补充的指南。
要点
TdP是一种常致命的心律失常，可由电解质紊乱继发的QT间期延长引起。大量输血可使患者易发生电解质耗竭、QT间期延长和TdP。有必要进一步完善关于电解质监测和QT间期评估的指南，以预防TdP等并发症。
Zotero 插件