Transfusion-associated hyperkalemia in pediatric population: Prevalence, risk factors, survival, infusion rate, and RBC unit features.

Tytuł:: Transfusion-associated hyperkalemia in pediatric population: Prevalence, risk factors, survival, infusion rate, and RBC unit features.
Autorzy:: Yamada C; Department of Pathology, Division of Transfusion Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Edelson M; Department of Pathology and Laboratory Medicine, Nemours/A.I. DuPont Hospital for Children, Wilmington, Delaware, USA.
Lee A; Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, George Washington School of Medicine & Health Sciences, Washington, District of Columbia, USA.
Saifee NH; Department of Pathology and Laboratory Medicine, Division of Transfusion Medicine, Seattle Children's and University of Washington, Seattle, Washington, USA.
Bahar B; Division of Pathology & Laboratory Medicine, Children's National Hospital, George Washington School of Medicine & Health Sciences, Washington, District of Columbia, USA.
Delaney M; Division of Pathology & Laboratory Medicine, Children's National Hospital, George Washington School of Medicine & Health Sciences, Washington, District of Columbia, USA.
Źródło:: Transfusion [Transfusion] 2021 Apr; Vol. 61 (4), pp. 1093-1101. Date of Electronic Publication: 2021 Feb 10.
Typ publikacji:: Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Original Publication: Arlington, Va. : American Association Of Blood Banks
MeSH Terms:: Erythrocyte Transfusion*/adverse effects
Hyperkalemia*/diagnosis
Hyperkalemia*/epidemiology
Hyperkalemia*/etiology
Hyperkalemia*/mortality
Infusions, Intravenous*/adverse effects
Infusions, Intravenous*/statistics & numerical data
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Case-Control Studies ; Comorbidity ; Mortality/trends ; Potassium/blood ; Prevalence ; Retrospective Studies ; Risk Factors ; Transfusion Medicine/statistics & numerical data
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Contributed Indexing:: Keywords: RBC transfusion; non infectious; transfusion complications; transfusion practices (neonatal, pediatrics)
Substance Nomenclature:: RWP5GA015D (Potassium)
Entry Date(s):: Date Created: 20210210 Date Completed: 20210701 Latest Revision: 20240319
Update Code:: 20240320
DOI:: 10.1111/trf.16300
PMID:: 33565635
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Background: Hyperkalemia is a rare life-threatening complication of red blood cell (RBC) transfusion. Stored RBCs leak intracellular potassium (K+) into the supernatant; irradiation potentiates the K+ leak. As the characteristics of patients and implicated RBCs have not been studied systematically, a multicenter study of transfusion-associated hyperkalemia (TAH) in the pediatric population was conducted through the AABB Pediatric Transfusion Medicine Subsection.
Study Design: The medical records of patients <18 years old were retrospectively queried for hyperkalemia occurrence during or ≤12 h after the completion of RBC transfusion in a 1-year period. Collected data included patient demographics, diagnosis, medical history, timing of hyperkalemia and transfusion, mortality, and RBC unit characteristics.
Results/findings: A total of 3777 patients received 19,649 RBC units during the study period in four facilities. TAH was found in 35 patients (0.93%) in 37 occurrences. The patient median age and weight were 1.28 years and 9.80 kg, respectively. All patients had multiple serious comorbidities. There were 79 RBC units transfused in the TAH events; 62% were irradiated, and the median age of the units was 10 days. The median total RBC volume transfused ≤12 h before TAH was 24% of patient estimated total blood volume, and the median infusion rate (IR) was19.6 ml/kg/h. Mortality rate within 1 day after the TAH event was 20%.
Conclusions: The prevalence of TAH in children was low; however, the 1-day mortality rate was 20%. Patients with multiple comorbidities may be at higher risk for TAH. The IR was higher for patients who had TAH than the IR threshold for safe transfusion.
(© 2021 AABB.)

Comment in: Transfusion. 2021 Apr;61(4):996-999. (PMID: 33831227)
Comment in: Transfusion. 2022 Jan;62(1):252-253. (PMID: 35023158)

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