Hyperkalemia Following Massive Transfusion in Trauma1

Brigham K. Au, William D. Dutton, Victor Zaydfudim, Timothy C. Nunez, Pampee P. Young, Bryan A. Cotton

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Large-volume blood transfusions have been implicated in the development of hyperkalemia. The purpose of the current study was to determine whether critically injured patients receiving massive transfusions are at an increased risk of hyperkalemia. Methods: Massive transfusion (MT) cohort, all trauma patients (02/2004-01/2008) taken directly to the OR and receiving ≥10 units of RBC in first 24h. Comparison cohort (No-RBC), all patients (02/2004-01/2008) transported directly to the OR who received no blood products in the first 24h. Hyperkalemia defined as K+ > 5.5 mEq/L. Results: There were 266 MT patients, 237 No-RBC patients. MT patients were more likely to have hyperkalemia in the immediate postoperative setting (1.8% versus 4.6%, P = 0.049). However, linear regression did not identify intraoperative blood transfusions as a predictor of postoperative K+ values (P = 0.417). Logistic regression identified only preop K+ (OR 1.79, P = 0.021) and postop pH (OR 0.009, P = 0.001), but not MT, as independent risk factors for postop hyperkalemia. Conclusions: Despite concerns of hyperkalemia following MT, we found less than a 5% incidence of postop K+ (>5.5 mEq/L). After adjusting for the significant effects of preop K+ and postop pH, MT patients were at no higher risk of hyperkalemia than those who received no blood products.

Original languageEnglish (US)
Pages (from-to)284-289
Number of pages6
JournalJournal of Surgical Research
Volume157
Issue number2
DOIs
StatePublished - Dec 1 2009

Fingerprint

Hyperkalemia
Blood Transfusion
Linear Models
Logistic Models
Incidence
Wounds and Injuries

Keywords

  • hyperkalemia
  • massive transfusion
  • potassium
  • red blood cells
  • trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Au, B. K., Dutton, W. D., Zaydfudim, V., Nunez, T. C., Young, P. P., & Cotton, B. A. (2009). Hyperkalemia Following Massive Transfusion in Trauma1 Journal of Surgical Research, 157(2), 284-289. https://doi.org/10.1016/j.jss.2009.05.009

Hyperkalemia Following Massive Transfusion in Trauma1 . / Au, Brigham K.; Dutton, William D.; Zaydfudim, Victor; Nunez, Timothy C.; Young, Pampee P.; Cotton, Bryan A.

In: Journal of Surgical Research, Vol. 157, No. 2, 01.12.2009, p. 284-289.

Research output: Contribution to journalArticle

Au, BK, Dutton, WD, Zaydfudim, V, Nunez, TC, Young, PP & Cotton, BA 2009, 'Hyperkalemia Following Massive Transfusion in Trauma1 ', Journal of Surgical Research, vol. 157, no. 2, pp. 284-289. https://doi.org/10.1016/j.jss.2009.05.009
Au BK, Dutton WD, Zaydfudim V, Nunez TC, Young PP, Cotton BA. Hyperkalemia Following Massive Transfusion in Trauma1 Journal of Surgical Research. 2009 Dec 1;157(2):284-289. https://doi.org/10.1016/j.jss.2009.05.009
Au, Brigham K. ; Dutton, William D. ; Zaydfudim, Victor ; Nunez, Timothy C. ; Young, Pampee P. ; Cotton, Bryan A. / Hyperkalemia Following Massive Transfusion in Trauma1 In: Journal of Surgical Research. 2009 ; Vol. 157, No. 2. pp. 284-289.
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abstract = "Background: Large-volume blood transfusions have been implicated in the development of hyperkalemia. The purpose of the current study was to determine whether critically injured patients receiving massive transfusions are at an increased risk of hyperkalemia. Methods: Massive transfusion (MT) cohort, all trauma patients (02/2004-01/2008) taken directly to the OR and receiving ≥10 units of RBC in first 24h. Comparison cohort (No-RBC), all patients (02/2004-01/2008) transported directly to the OR who received no blood products in the first 24h. Hyperkalemia defined as K+ > 5.5 mEq/L. Results: There were 266 MT patients, 237 No-RBC patients. MT patients were more likely to have hyperkalemia in the immediate postoperative setting (1.8{\%} versus 4.6{\%}, P = 0.049). However, linear regression did not identify intraoperative blood transfusions as a predictor of postoperative K+ values (P = 0.417). Logistic regression identified only preop K+ (OR 1.79, P = 0.021) and postop pH (OR 0.009, P = 0.001), but not MT, as independent risk factors for postop hyperkalemia. Conclusions: Despite concerns of hyperkalemia following MT, we found less than a 5{\%} incidence of postop K+ (>5.5 mEq/L). After adjusting for the significant effects of preop K+ and postop pH, MT patients were at no higher risk of hyperkalemia than those who received no blood products.",
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AB - Background: Large-volume blood transfusions have been implicated in the development of hyperkalemia. The purpose of the current study was to determine whether critically injured patients receiving massive transfusions are at an increased risk of hyperkalemia. Methods: Massive transfusion (MT) cohort, all trauma patients (02/2004-01/2008) taken directly to the OR and receiving ≥10 units of RBC in first 24h. Comparison cohort (No-RBC), all patients (02/2004-01/2008) transported directly to the OR who received no blood products in the first 24h. Hyperkalemia defined as K+ > 5.5 mEq/L. Results: There were 266 MT patients, 237 No-RBC patients. MT patients were more likely to have hyperkalemia in the immediate postoperative setting (1.8% versus 4.6%, P = 0.049). However, linear regression did not identify intraoperative blood transfusions as a predictor of postoperative K+ values (P = 0.417). Logistic regression identified only preop K+ (OR 1.79, P = 0.021) and postop pH (OR 0.009, P = 0.001), but not MT, as independent risk factors for postop hyperkalemia. Conclusions: Despite concerns of hyperkalemia following MT, we found less than a 5% incidence of postop K+ (>5.5 mEq/L). After adjusting for the significant effects of preop K+ and postop pH, MT patients were at no higher risk of hyperkalemia than those who received no blood products.

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