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[Metabolic disorders caused by blood transfusions].

H J Schmitt1, E Götz

  • 1Institut für Anaesthesiologie, Städtische Kliniken Darmstadt.

Infusionstherapie (Basel, Switzerland)
|December 1, 1988
PubMed
Summary

Stored blood transfusions can cause metabolic changes like low 2,3-diphosphoglycerate (2,3-DPG), acidosis, and hyperkalemia. These can impair heart function in patients with coronary artery disease, especially under hypothermia or shock.

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Area of Science:

  • Transfusion Medicine
  • Physiology
  • Biochemistry

Background:

  • Stored blood undergoes metabolic alterations over time, including 2,3-diphosphoglycerate (2,3-DPG) depletion, acidosis, and hyperkalemia.
  • Citrate in preservatives binds ionized calcium, potentially leading to hypocalcemia.
  • These storage-related changes can manifest in recipients following massive transfusions.

Purpose of the Study:

  • To investigate the physiological consequences of metabolic changes in stored blood following massive transfusions.
  • To assess the impact of these changes on recipient cardiovascular function, particularly in patients with coronary artery disease.

Main Methods:

  • Analysis of metabolic changes in stored erythrocytes, including 2,3-DPG levels and oxygen affinity.
  • Monitoring of recipient electrolyte and acid-base balance (acidosis, hypocalcemia, hyperkalemia) post-transfusion.
  • Evaluation of cardiac function in patients with coronary artery disease receiving massive transfusions.

Main Results:

  • Depletion of 2,3-DPG in stored erythrocytes leads to increased oxygen affinity.
  • Massive transfusions can induce acidosis, hypocalcemia, and hyperkalemia in recipients.
  • Patients with coronary artery disease exhibit impaired heart function under these transfusion-induced metabolic conditions.

Conclusions:

  • Metabolic derangements from stored blood transfusions, such as 2,3-DPG depletion and electrolyte imbalances, pose risks to recipients.
  • Impaired compensatory mechanisms in hypothermia or shock can exacerbate transfusion-related metabolic disturbances.
  • Regular monitoring via ECG and acid-base analysis is crucial for detecting and managing these critical changes.

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