Transfusion-associated hyperkalemia in pediatric population: Analyses for risk factors and recommendations.
Transfusion-associated hyperkalemia in pediatric population: Analyses for risk factors and recommendations.
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DOI：
10.1111/trf.17135
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发表时间：
2022-12
期刊：
影响因子：
2.9
通讯作者：
Dinov, Ivo D.
中科院分区：
文献类型：
--
作者：
Yamada, Chisa;Edelson, Maureen F.;Lee, Angela C.;Saifee, Nabiha H.;Dinov, Ivo D.
输血相关性高钾血症（TAH）是红细胞（RBC）输注的潜在危及生命的并发症。以前，我们报告了35例在4家机构接受红细胞输注的高钾血症儿科患者（TAH组）的红细胞输注特征。在这项研究中，我们使用多变量分析和人工智能来比较TAH组和新收集的对照组（非TAH组），以确定与TAH发生相关的因素。对TAH患者的RBC输注情况进行了审查，并将其与同一年期间在每家医疗机构未发生TAH患者的非TAH组进行了比较。非TAH组包括5个年龄组各12例患者。采用Wilcoxon秩和检验递归特征消除、最小绝对收缩和选择算子（LASSO）以及其他人工智能技术来识别与预测TAH发生的特定临床结局相关的最显著特征。TAH组和非TAH组之间的输血前肌酐、肾和/或肝功能障碍的合并症以及12小时内每Kg和每估计总血量（eTBV）的总输血量（tV-12）显示出统计学显著差异。多变量分析显示，影响TAH发生的最大因素是tV-12/Kg，其次是RBC单位的年龄。风险阈值为tV-12/Kg为30 ml/Kg，tV-12/eTBV为30%，RBC单位年龄为7.95天。研究结果表明，对TAH发生影响最大的因素是tV-12/Kg。更重要的是，在有多种合并症的患者中，30%的eTBV输血可能导致TAH。
Transfusion-associated hyperkalemia (TAH) is a potentially life-threatening complication of red blood cell (RBC) transfusion. Previously, we reported features of RBC transfusions from 35 pediatric patients (TAH group) who had hyperkalemia with RBC transfusion in one-year period at 4 facilities. In this study, we used multivariate analyses and artificial intelligence to compare the TAH group to newly collected control group (non-TAH group) to identify factors associated with TAH occurrence. A review of RBC transfusion with TAH were compared to non-TAH group who did not develop TAH with RBC transfusion at each facility during the same one-year period. The non-TAH group included 12 patients each in 5 age groups. Wilcoxon rank-sum tests recursive feature elimination, least absolute shrinkage, and selection operator (LASSO), and other artificial intelligence techniques were employed to identify the most salient features associated with predicting specific clinical outcomes for TAH occurrence. Pre-transfusion creatinine, comorbidities of kidney and/or liver dysfunctions, and total transfused volume within 12 hours (tV-12) per Kg and per estimated total blood volume (eTBV) showed statistically significant differences between TAH and non-TAH groups. Multivariate analysis revealed the biggest factor on TAH occurrence was tV-12/Kg followed by age of RBC units. The thresholds of risks were tV-12/Kg of 30 ml/Kg, tV-12/eTBV of 30%, and RBC unit age of 7.95 days. The study findings suggest that the biggest factor on TAH occurrence is tV-12/Kg. More importantly, 30% of eTBV transfusion could cause TAH in the patients with multiple comorbidities.
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影响因子：
46.9
作者：
Becht, Etienne;McInnes, Leland;Newell, Evan W.
通讯作者：
Newell, Evan W.
影响因子：
3.3
作者：
Fay MP;Proschan MA
通讯作者：
Proschan MA
影响因子：
4.3
作者：
Mosavi, Amirhosein;Sajedi Hosseini, Farzaneh;Rafiei Sardooi, Elham
通讯作者：
Rafiei Sardooi, Elham
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
2.6
作者：
Burke M;Sinha P;Luban NLC;Posnack NG
通讯作者：
Posnack NG