Hyperkalemia After Packed Red Blood Cell Transfusion in Trauma Patients.

摘要

A spectrum of derangements of potassium homeostasis have been reported on patients undergoing transfusion with cell-based transfusion products, specifically, packed red blood cells (PRBCs) and fresh whole blood. In both adults and children, hypokalemia has been reported more frequently than hyperkalemia. The largest reported series of which we are aware, retrospective in nature, reported an incidence of hypokalemia of 72% in children undergoing liver transplantation; hyperkalemia occurred in less than 5% of patients. Others have likewise observed hypokalemia to be more common after transfusion. In the few, small studies describing hyperkalemia after transfusion of blood products, elevations of serum potassium levels have been described alternatively as transient and clinically insignificant. We have previously reported an independent association between the number of transfused blood products, both cell and noncell-based, and the development of hyperkalemia in a noncrush trauma population undergoing acute resuscitation after major penetrating trauma. In this population, hyperkalemia was common, often severe, but transient; however, there was a trend toward higher mortality in those patients who developed hyperkalemia compared with those who did not. To better delineate the role of cell-based transfusion, specifically PRBCs and fresh whole blood, in the development of hyperkalemia, we retrospectively analyzed data for a cohort of trauma patients undergoing acute resuscitative interventions after admission to a combat support hospital in central Iraq.