2013
DOI: 10.1111/trf.12192
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Transfusion‐associated hyperkalemic cardiac arrest in pediatric patients receiving massive transfusion

Abstract: Key points identified from this literature search are as follows: 1) Case reports are skewed toward infants and neonates in particular and 2) the rate of blood transfusion, more so than total volume, cardiac output, and the site of infusion, are key factors in the development of TAHCA. Measures to reduce the risk of TAHCA in young children include anticipating and replacing blood loss before significant hemodynamic compromise occurs, using larger-bore (>23-gauge) peripheral intravenous catheters rather than ce… Show more

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Cited by 103 publications
(69 citation statements)
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References 40 publications
(145 reference statements)
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“…It has been demonstrated that stored blood increases its extracellular potassium level over time. Within the first week levels were less than 20 mEq/L, and they rose to greater than 40 mEq/L after two weeks of storage [25]. This is thought to be an under-appreciated risk in clinical practice, as highlighted by a report of cardiac arrests in pediatric patients receiving massive transfusions [25].…”
Section: Blood Transfusionsmentioning
confidence: 96%
“…It has been demonstrated that stored blood increases its extracellular potassium level over time. Within the first week levels were less than 20 mEq/L, and they rose to greater than 40 mEq/L after two weeks of storage [25]. This is thought to be an under-appreciated risk in clinical practice, as highlighted by a report of cardiac arrests in pediatric patients receiving massive transfusions [25].…”
Section: Blood Transfusionsmentioning
confidence: 96%
“…Several cases of whole blood transfusion leading to cardiac arrest and death in infants have been described. [23][24][25][26][27] The ABCB6 FP mutants overexpressed in HEK-293 cells showed no difference in accumulation of mRNA or protein, or in peripheral membrane immunolocalization as compared to WT ABCB6, and as previously demonstrated for the ABCB6 FP variant R375Q.…”
Section: Discussionmentioning
confidence: 78%
“…8 Particular consideration should be directed towards hyperkalemia and hypocalcemia which can result from large-volume blood transfusions. 9 Vigilance is needed to detect early signs of hyperkalemia (peak T waves, shortened QT interval, ST depression etc.). Furthermore, some blood preparation strategies, such as irradiation to reduce the risk of graft vs host reaction, may increase the risk of hyperkalemia.…”
Section: Discussionmentioning
confidence: 99%
“…In addition, his intravenous methylprednisolone was transitioned to oral prednisolone that was slowly tapered over three months to 0.2 mgÁkg -1 Áday -1 . He was restarted on his preoperative tacrolimus with a targeted level of [8][9][10][11][12] ngÁmL -1 , and his mycophenolate dose increased to 400 mg q 12 hr postoperatively. Cefazolin was continued postoperatively for antibiotic prophylaxis, and daily cotrimoxazole (trimethoprim/sulfamethoxazole) was administered for one year.…”
Section: Clinical Casementioning
confidence: 99%