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KMID : 0604020150300020132
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Korean Journal of Critical Care Medicine
2015 Volume.30 No. 2 p.132 ~ p.134
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Transfusion Associated Hyperkalemia and Cardiac Arrest in an Infant after Extracorporeal Membrane Oxygenation
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Kim Do-Wan
Cheon Kyeong-Ryeol
Cho Duck
Cho Hwa-Jin
Jeong In-Seok
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Abstract
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Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report acase of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-monthold infant. Her serum potassiumlevel was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell(RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient.Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiatedand washed RBCs shouldbe used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possiblecomplicationsassociated with transfusions during ECMO.
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KEYWORD
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blood transfusion, extracorporeal membrane oxygenation, heart arrest, hyperkalemia
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