The administration of packed red blood cells and its influence on electrolyte and acid-base balance disturbances in vivo

Česká verzia

Authors: Uvízl Radovan; Klementa Bronislav; Neiser Jan; Fritscherová Šárka; Adamus Milan
Authors place of work: Klinika anesteziologie a resuscitace, Fakultní nemocnice Olomouc
Published in the journal: Anest. intenziv. Med., 22, 2011, č. 1, s. 13-18
Category: Intenzivní medicína - Původní práce

Summary

Objective:
Administration of large-volume blood transfusions can cause electrolyte and acid-base balance disturbances in the plasma of the patient. The ongoing metabolism and haemolysis in the transfusion unit can change the initial values of some biochemical parameters. The aim of this study was to describe the influence of the number of transfusion units and their age on the biochemical values in vivo.

Design:
Prospective observational study.

Setting:
Multidisciplinary intensive care unit (ICU) in a tertiary care centre.

Materials and methods:
We compared the biochemical values in the arterial blood before and after the administration of the transfusion. We recorded the data and analysed their dependence on the volume and duration of storage of the administered transfusion units (TU).

Results:
We examined 46 patients who received total 354 TUs of packed red blood cells (PRBC), mean 7.7 (range 2–38) TU of PRBC per patient. The mean duration of storage of the administrated PRBC was 16.2 days. The administration of 1 TU of PRBC led to a rise of K⁺ values by 0.07 mmol/l and a rise of lactate values by 0.13 mmol/l. Other biochemical values (pH, Ca⁺⁺, Na⁺, glycaemia) were stable.

Conclusion:
The administration of large-volume blood transfusion can pose a significant risk of hyperkalaemia and hyperlactataemia.

Keywords:
erythrocyte – transfusion – hyperkalaemia – lactataemia – PRBC

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