Transfusion-Associated Hyperkalemic Cardiac Arrest in Neonatal, Infant, and Pediatric Patients.
Transfusion-Associated Hyperkalemic Cardiac Arrest in Neonatal, Infant, and Pediatric Patients.
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DOI：
10.3389/fped.2021.765306
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发表时间：
2021
影响因子：
2.6
通讯作者：
Posnack NG
中科院分区：
文献类型：
--
作者：
Burke M;Sinha P;Luban NLC;Posnack NG
输注红细胞(RBC)是一种挽救生命的干预措施，美国每年有近1400万个红细胞单位被输注。然而，红细胞的收集、处理和管理的不同可能会影响这一程序的安全性和有效性。增加储存血液产品中钾(K+)水平的程序或操作也可能使患者容易发生高钾血症和输血相关的高钾性心脏骤停(TAHCA)。在这篇简短的综述中，我们旨在提供血液储存、红细胞储存损伤以及增加细胞外[K+]的变量的简要概述。我们还总结了TAHCA的案例，并确定了潜在的缓解策略。在儿童患者中，当红细胞快速输注、直接输送到心脏而没有时间进行电解质平衡，或者由于储存时间或照射而积聚细胞外K+时，可能会发生高钾血症和心律失常。血库的进步提高了红细胞的可获得性和质量，然而，一些患者对输血相关的高钾血症很敏感。未来的研究应该进一步研究降低TAHCA风险的潜在缓解策略，其中可能包括使用新鲜红细胞，减少照射后的储存时间，以较慢的速度输血，实施清洗或去除多余细胞外K+的操作，以及实施限制性输血策略。
Red blood cell (RBC) transfusions are a life-saving intervention, with nearly 14 million RBC units transfused in the United States each year. However, the safety and efficacy of this procedure can be influenced by variations in the collection, processing, and administration of RBCs. Procedures or manipulations that increase potassium (K+) levels in stored blood products can also predispose patients to hyperkalemia and transfusion-associated hyperkalemic cardiac arrest (TAHCA). In this mini review, we aimed to provide a brief overview of blood storage, the red cell storage lesion, and variables that increase extracellular [K+]. We also summarize cases of TAHCA and identify potential mitigation strategies. Hyperkalemia and cardiac arrhythmias can occur in pediatric patients when RBCs are transfused quickly, delivered directly to the heart without time for electrolyte equilibration, or accumulate extracellular K+ due to storage time or irradiation. Advances in blood banking have improved the availability and quality of RBCs, yet, some patient populations are sensitive to transfusion-associated hyperkalemia. Future research studies should further investigate potential mitigation strategies to reduce the risk of TAHCA, which may include using fresh RBCs, reducing storage time after irradiation, transfusing at slower rates, implementing manipulations that wash or remove excess extracellular K+, and implementing restrictive transfusion strategies.
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DOI：
10.1097/pcc.0000000000001600
发表时间：
2018-09
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Bembea MM;Cheifetz IM;Fortenberry JD;Bunchman TE;Valentine SL;Bateman ST;Steiner ME;Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI);Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
通讯作者：
Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
影响因子：
4.1
作者：
Cholette, Jill M.;Pietropaoli, Anthony P.;Blumberg, Neil
通讯作者：
Blumberg, Neil
影响因子：
2.9
作者：
D'Alessandro, Angelo;Culp-Hill, Rachel;Cristman, A. M.
通讯作者：
Cristman, A. M.
影响因子：
37.8
作者：
Donadee C;Raat NJ;Kanias T;Tejero J;Lee JS;Kelley EE;Zhao X;Liu C;Reynolds H;Azarov I;Frizzell S;Meyer EM;Donnenberg AD;Qu L;Triulzi D;Kim-Shapiro DB;Gladwin MT
通讯作者：
Gladwin MT
影响因子：
--
作者：
Arora S;Marwaha N;Dhawan HK;Rao KLN
通讯作者：
Rao KLN