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Background: Hyperkalemic cardiac arrest is a potential complication of massive transfusion in children. Our objective was to identify risk factors and potential preventive measures by reviewing the literature on transfusion-associated hyperkalemic cardiac arrest (TAHCA) in the pediatric population.
Study Design And Methods: Literature searches were performed in MEDLINE and the Cochrane Database of Systematic Reviews.
Results: We identified nine case reports of pediatric patients who had experienced cardiac arrest during massive transfusion. Serum potassium concentration was reported in eight of those reports; the mean was 9.2 ± 1.8 mmol/L. Risk factors for TAHCA noted in the case reports included infancy (n = 6); age of red blood cells (RBCs; n = 5); site of transfusion (n = 5); and the presence of comorbidities such as hyperkalemia, hypocalcemia, acidemia, and hypotension (n = 9). We also identified 13 clinical studies that examined potassium levels associated with transfusion. Of those 13, five studied routine transfusion, two were registries, and six examined massive transfusion.
Conclusions: Key points identified from this literature search are as follows: 1) Case reports are skewed toward infants and neonates in particular and 2) the rate of blood transfusion, more so than total volume, cardiac output, and the site of infusion, are key factors in the development of TAHCA. Measures to reduce the risk of TAHCA in young children include anticipating and replacing blood loss before significant hemodynamic compromise occurs, using larger-bore (>23-gauge) peripheral intravenous catheters rather than central venous access, checking and correcting electrolyte abnormalities frequently, and using fresher RBCs for massive transfusion.
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http://dx.doi.org/10.1111/trf.12192 | DOI Listing |
Mol Neurobiol
December 2024
Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
Astrocytes are abundant glial cells in the central nervous system (CNS) that play important roles in brain injury following cardiac arrest (CA). Following brain ischemia, astrocytes trigger endogenous neuroprotective mechanisms, such as fatty acid transport. Lipid droplets (LDs) are cellular structures involved in neutral lipid storage and play essential roles in many biological processes.
View Article and Find Full Text PDFExpert Rev Med Devices
December 2024
Department of Pain Management, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Introduction: Out-of-hospital cardiac arrest (OHCA) is characterized by the cessation of mechanical cardiac activity and voluntary circulation occurring outside of a hospital setting, making it the leading cause of death worldwide. Recently, the optimal approach to airway management has been a subject of controversy.
Methods: Follow PRISMA guidelines for systematic evaluation and meta-analysis.
J Extra Corpor Technol
December 2024
Physiology Research Center, Iran University of Medical Sciences, Tehran 1449614535, Iran.
Introduction: Myocardial protection with cardioplegia is a crucial approach to mitigate myocardial damage during coronary bypass grafting surgery (CABG) with cardiopulmonary bypass (CPB). The major component of the del Nido cardioplegia solution, Plasma-Lyte A, is difficult to obtain in Iran due to high cost. The objective of the current study was to study if the lactated Ringer's solution as the base for del Nido solution (LR DN) usage is a viable option as a substitute for Plasma-Lyte A in adult patients presenting for CABG surgery.
View Article and Find Full Text PDFResusc Plus
December 2024
Department of Critical Care Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Background: Hypoxic hepatitis (HH) is commonly seen in critically ill patients, such as those with cardiac shock, sepsis, and respiratory failure. However, data are limited regarding its impact on the prognosis of patients with cardiac arrest (CA).
Methods: We conducted a systematic review and meta-analysis of studies from PubMed, EMBASE, and the Cochrane Library from inception to July 30, 2024.
Cureus
November 2024
Medicine and Surgery, Royal Devon University Healthcare NHS Foundation Trust, Exeter, GBR.
Timely gathering of equipment for venepuncture or cannulation on hospital wards is important, particularly in emergency situations. Anecdotally several doctors working at a hospital in England expressed frustration at low equipment stock, layout, and discrepancies between wards leading to significant delays in this process. This quality improvement project therefore aimed to reduce the time taken to gather equipment for venepuncture or cannulation to 20 seconds by June 2023.
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