Severe hyperkalemia following blood transfusions: Is there a link?

Rizos, Christos V.; Milionis, Haralampos; Elisaf, Moses

doi:10.5527/wjn.v6.i1.53

Cited by 10 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous reports of TAH, many patients were pediatric patients, especially neonates; 9-14 however, a significant amount of the literature reported adult patients who developed TAH. [14][15][16][17][18] Our study also shows that the age group of 1-5 years had the biggest prevalence of TAH, but seven patients were in the age group of 11 to <18 years, some of whom had an adult body size. Therefore, TAH may occur not only in the patients with a smaller body size, as we expected, but also in the patients with an adult body size.…”

Section: Discussionsupporting

confidence: 64%

“…Serious repercussions of TAH with or without cardiac arrest have been reported, [9][10][11][12][13][14][15][16][17][18] raising concerns for the risks of TAH from large-volume transfusions with or without a rapid IR for pediatric patients, especially for infants. 19,20 Patients who are undergoing procedures such as cardiac surgeries using cardiopulmonary bypass (CPB), extracorporeal membrane oxygenation (ECMO), RBC exchange, and liver transplantations may receive large-volume RBC transfusions rapidly and may be at increased risk for TAH.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transfusion‐associated hyperkalemia in pediatric population: Prevalence, risk factors, survival, infusion rate, and RBC unit features

et al. 2021

View full text Add to dashboard Cite

Background Hyperkalemia is a rare life‐threatening complication of red blood cell (RBC) transfusion. Stored RBCs leak intracellular potassium (K+) into the supernatant; irradiation potentiates the K+ leak. As the characteristics of patients and implicated RBCs have not been studied systematically, a multicenter study of transfusion‐associated hyperkalemia (TAH) in the pediatric population was conducted through the AABB Pediatric Transfusion Medicine Subsection. Study Design The medical records of patients <18 years old were retrospectively queried for hyperkalemia occurrence during or ≤12 h after the completion of RBC transfusion in a 1‐year period. Collected data included patient demographics, diagnosis, medical history, timing of hyperkalemia and transfusion, mortality, and RBC unit characteristics. Results/Findings A total of 3777 patients received 19,649 RBC units during the study period in four facilities. TAH was found in 35 patients (0.93%) in 37 occurrences. The patient median age and weight were 1.28 years and 9.80 kg, respectively. All patients had multiple serious comorbidities. There were 79 RBC units transfused in the TAH events; 62% were irradiated, and the median age of the units was 10 days. The median total RBC volume transfused ≤12 h before TAH was 24% of patient estimated total blood volume, and the median infusion rate (IR) was19.6 ml/kg/h. Mortality rate within 1 day after the TAH event was 20%. Conclusions The prevalence of TAH in children was low; however, the 1‐day mortality rate was 20%. Patients with multiple comorbidities may be at higher risk for TAH. The IR was higher for patients who had TAH than the IR threshold for safe transfusion.

show abstract

Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Transfusion‐associated hyperkalemia in pediatric population: Prevalence, risk factors, survival, infusion rate, and RBC unit features

et al. 2021

View full text Add to dashboard Cite

show abstract

“…It was reported that supernatant potassium concentration of stored blood was frequently higher than potassium levels in normal human plasma, and that rapid intravenous infusion might allow a mass of potassium into receiver's body in a short time, thus swiftly increasing blood potassium concentration. [ 29 , 30 ] However, the specific mechanisms of blood transfusion inducing hyperkalemia remain unclear. Besides, surgical procedure represented another potential risk factor for hyperkalemia.…”

Section: Discussionmentioning

confidence: 99%

Safety of potassium-bearing citrate in patients with renal transplantation

Wang

Cui²,

Zhang³

et al. 2017

Medicine

View full text Add to dashboard Cite

Rationale:Urinary lithiasis is one of severe postoperative complications in patients undergoing renal transplantation, possibly leading to anuria, urinary infection, or even acute renal failure. Potassium sodium hydrogen citrate (PSHC), a potassium-bearing citrate, is commonly prescribed to prevent stone formation.Patient concerns:A 25-year-old man (patient 1) and a 31-year-old man (patient 2) receiving renal transplantation for end-stage renal disease (ESRD) were enrolled in this study. They were given 10 g/day of PSHC granules from the ninth day to the 17th day after surgery. Patient 1 presented chest tightness, nausea, muscle weakness, and ascending paralysis on the 10th day. Patient 2 presented weak waves on EGG on the 17th day. Moreover, their serum potassium concentrations (SPCs) were 7.67 and 6.05 mmol/L, respectively.Diagnosis:Acute hyperkalemia.Interventions:Hemo-filtration was performed for patient 1, while patient 2 received 10% calcium gluconate 10 mL, 5% NaHCO3 125 mL, and 10% glucose 500 mL with the addition of 10 units of insulin through intravenous drip.Outcomes:Their SPCs dropped to the normal range.Lessons:Physicians should pay close attentions to potential risks caused by PSHC, and monitor the SPCs to minimize the occurrence of hyperkalemia.

show abstract

“…Hyperkalemia is usually associated with pediatric transfusion; it is considered a transient effect of rapid blood infusion in adults. 1,11,12 Fatal cardiac effects are the most feared consequences of hyperkalemia. The effects of hyperkalemia range from electrocardiographic changes (peaked T waves, loss of P-wave amplitude, prolonged PR interval, and QRS duration) to ventricular fibrillation or asystole, leading to mechanical arrest of the heart and death in the most severe cases.…”

mentioning

confidence: 99%

“…Hyperkalemia, or excess of potassium (K + ) in blood, is a well‐recognized adverse effect of transfusion. Hyperkalemia is usually associated with pediatric transfusion; it is considered a transient effect of rapid blood infusion in adults 1,11,12 . Fatal cardiac effects are the most feared consequences of hyperkalemia.…”

mentioning

confidence: 99%