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Hyperkalemia following massive transfusion in trauma
Brigham K Au1, William D Dutton, Victor Zaydfudim
1Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
The Journal of Surgical Research
|September 22, 2009
Summary
Massive transfusions (MT) in trauma patients did not increase hyperkalemia risk. Postoperative potassium levels were similar between MT and no-RBC groups after adjusting for pre-existing conditions.
Area of Science:
- Critical care medicine
- Trauma surgery
- Transfusion medicine
Background:
- Large-volume blood transfusions are suspected to cause hyperkalemia.
- Assessing hyperkalemia risk in trauma patients receiving massive transfusions is crucial.
Purpose of the Study:
- To investigate the association between massive transfusions and hyperkalemia in critically injured trauma patients.
Main Methods:
- A cohort study compared trauma patients receiving massive transfusions (≥10 units RBC in 24h) with those receiving no blood products.
- Hyperkalemia was defined as serum potassium > 5.5 mEq/L.
Main Results:
- Massive transfusion patients showed a slightly higher incidence of hyperkalemia (4.6% vs 1.8%), but this was not statistically significant after adjustments.
- Intraoperative transfusions were not a predictor of postoperative potassium levels.
- Preoperative potassium and postoperative pH were independent risk factors for hyperkalemia.
Conclusions:
- Massive transfusion in trauma patients is not an independent risk factor for postoperative hyperkalemia.
- The incidence of hyperkalemia in massive transfusion patients is low (<5%).
- Preoperative potassium and postoperative pH are key predictors of hyperkalemia in this population.
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