Measuring Potassium Level in Packed Red Blood Cells Before Using: Word of Caution for Congenital Cardiac Surgery

Altun D., Arnaz A., Doğan A., Yalçınbaş Y., Türköz R., Altun D., ...More

17th World Congress of Anesthesiology 2021, Praha, Czech Republic, 1 - 05 September 2021, no.3

  • Publication Type: Conference Paper / Summary Text
  • City: Praha
  • Country: Czech Republic
  • Acibadem Mehmet Ali Aydinlar University Affiliated: Yes


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.