17th World Congress of Anesthesiology 2021, Praha, Çek Cumhuriyeti, 1 - 05 Eylül 2021, sa.3
Background-aim of the study: Transfusion-associated hyperpotassemia is a serious complication of
packed red blood cell (PRBC) transfusion after congenital cardiac surgery. Our study aimed to identify
risk factors and potential preventive measures of transfusion-associated hyperpotassemia in
neonates and infants after congenital cardiac surgery.
Methods: Pediatric patients who underwent congenital cardiac surgery and need transfusion were
enrolled in this prospective study. The potassium concentration of PRBC was checked from the sample
taken from the segment. The volume of transfusion, age of PRBC, potassium concentration of
unit were recorded. The estimated increment of potassium level in patients after PRBC transfusion
was calculated.
Results: Seventy-four individual patients, 95 distinct transfusions, 112 blood products were evaluated.
The mean age of the blood unit was 3.8 ± 1.4 days. The mean potassium concentration in the
PRBCs was 9.9 ± 2.4 mmol/L. A weak correlation was observed between the potassium value of
the PRBC and the age of PRBC (p = 0.049, r = 0.2, y = 0.24 * x + -0.68). There was a weak correlation
between the potassium value of PRBCs and the age of the unit. (p <0.001, r = 0.37, y = 2.8 * x + -
3.6). The mean amount of potassium administered by blood transfusion was 0.40 ± 0.14 mmol/L and
varied between 0.16-0.95 mmol/L. A very weak correlation was observed between the amount of
potassium taken by transfusion and the change in the patient's potassium concentration (p = 0.01, r
= 0.26)
Conclusions: Before transfusion, even PRBC is fresh, measuring the potassium level of PRBC and the
potassium that will be given to the pediatric patient with transfusion can prevent transfusion-related
hyperpotassemia and related complications. Otherwise, high potassium levels, which may be overlooked
despite being fresh, may cause serious complications, even cardiac arrest, especially in neonates
and infants.