Hemorrhage and Transfusion as the Major Cause of Cardiac Arrest

LeVeen, Harry H.; Pasternack, Herbert S.; Lustrin, Irving; Shapiro, Robert; Becker, Eugene; Helft, Arthur E.

doi:10.1001/jama.1960.03020250026006

Cited by 50 publications

(7 citation statements)

References 7 publications

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“…Other investigators could not prove the expected increase of K + [46][47][48], and further study groups warn of a hypokalemia during massive transfusion [49][50]. Most studies are of older date and describe clinical situations during transfusion of whole blood [42,44,45,47,[49][50][51]. However, the same changes of K + in serum are described after administration of packed RBCs also [41,43].…”

Section: Hyperkalemiamentioning

confidence: 99%

Massive Transfusion and Its Influence on Oxygen Transport and Electrolyte Balance

Schmitt¹,

Lackes²

2000

Transfus Med Hemother

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During the process of storing erythrocyte-containing blood products, components of the preservatives and modifications of the erythrocyte function cause disorders of the electrolyte and acid-base balance as well as a deficiency of 2,3-diphosphoglycerate (2,3-DPG). Thereby transitory hyperkalemias may occur in the course of a massive transfusion, if the patient has a shock or another disturbance of the regulating mechanisms caused by diabetes mellitus or a treatment with β-blockers or ACE inhibitors. During the treatment with blood components, hypocalcemia and hypomagnesemia may develop after a dose of more than 12 fresh frozen plasms (FFP) per hour, if the metabolism of citrate, which binds bivalent cations as a chelate, is disturbed by hypothermia, shock or during the anhepatic stage of a liver transplantation. As a consequence, a low-output syndrome as well as tachyarrhythmias and torsades de pointes may develop. Whether the decrease of the 2,3-DPG level with the accompanying leftward shift of the oxyhemoglobin dissociation curve brings about a deficiency of the oxygen supply of the organs, has not yet been verified by experiment. The studies presented rather point at morphological changes of the erythrocytes due to the storage as the cause of the disturbances of capillary perfusion. For this reason patients with impending organ failure or marked disturbances of the coronary or cerebral perfusion should be transfused with packed red blood cells (RBCs) not older than 14 days.

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Section: Hyperkalemiamentioning

confidence: 99%

Massive Transfusion and Its Influence on Oxygen Transport and Electrolyte Balance

Schmitt¹,

Lackes²

2000

Transfus Med Hemother

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“…If anesthetized patients with a reduced thermoregulatory capability are infused rapidly with large amounts of cold blood, the heart and body temperatures [195,735,881, 938,1228,1229] fall; at the same time the oxygen consumption rises sharply [1209], which is absolutely undesirable during and after surgery. Children especially cannot produce the required amount of heat in a short time; ventricular fibrillation and cardiac arrest are observed as complications.…”

Section: Temperature Drop After Addition Of Larger Amounts Of Cold Bloodmentioning

confidence: 99%

Blood Replacement

Gruber¹

1969

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All rights reserved. No part of this book may be translated or reproduced in any form withoutwritten permission from Springer-Verlag. © by Springer-Verlag Berlin Heidelberg 1969. Library of Congress Catalog Card Number 69-16845Softcover reprint of the hardcover 1st edition 1969The use of general descriptive names, trade marks, etc. in this publication, even if the former are not especially identified, is not be taken as a sign that such names, as understood by the Trade Marks and Merchandise Act, may accordingly be used freely by anyone. Title-No. 1551 Dedicated to my wife LisaEs wurde fertig in Deiner Hut. Bleib Du mir auf dieser Erden, so 5011 alles fertig werden. THOMAS MANN ForewordThe manifold problems of shock are still of great importance, diagnostic and therapeutic experience of the "severely ill" being supplied with new information almost every month. In the 5 periodicals which have found their way to my desk during the past few days there are no less than 10 interesting articles on questions concerning shock research [see Bibliography 41 b, 53 a, 60 a, 192 a, 242 a, 350 b, 810 a, 941 a, 1069 a, 1082 a]. The most urgent point still is to maintain as complete as possible the objective catalog of the various shock manifestations found in man and in animals -yet at the same time to view interpretations of these phenomena in their relative and temporal "truth".Problems of shock research are not only interesting for their scientific value but also for their clinical implication. In particular, almost every practicing physician is facing problems of blood replacement very frequently. The effective or circulating blood volume remains an important theoretical and therapeutic problem in the shock field. For years, U. F. GRUBER has pursued this question clinically and experimentally. This volume deals with the world literature in an exceptionally thorough manner. This book is made more than a compilation by including a long list of original work done with F. D. MOORE in Boston, in the Surgical Department in Chur, with L. E. GELIN and S. E. BERGENTZ in Goteborg and in the Laboratory for Experimental Surgery in Davos; judgements are made on the basis of original studies, and essential points are separated from unimportant ones. This volume will be welcomed by the medical profession because it carefully treats vital questions concerning this complicated, much-discussed, and in part contested field, considering that today, along with various forms of blood and several plasma preparations, there are more than 40 different plasma replacement substances available with various physico-chemical, biological and pharmacological properties. Older preparations have been abandoned, others modified, and new ones appear.A comparative evaluation of the chemical characteristics, the range of indication and the therapeutic effectiveness of these solutions suggests itself particularly at this time because in recent years the use of large amounts of balanced electrolyte solutions tended to reverse the principles of blood replaceme...

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“…Both massive blood replacement and exchange transfusion consist of the rapid infusion of unphysiological ACD blood sometimes leading to a deterioration in electrocardiographic appearances and the condition of the patient (Van Praagh, 1961;Frank and Miraflor, 1968) and well reported as a cause of cardiac arrest due to asystole or ventricular fibrillation (Howland, Boyan and Schweitzer, 1956;McLean and van Tyn, 1961;Boyan and Howland, 1962;Le Veen et al, 1960). The reason for this is probably a combination of the factors examined below.…”

Section: Discussionmentioning

confidence: 99%

Massive Blood Replacement in Neonates and Children

Schroeder¹,

Forbes²

1969

British Journal of Anaesthesia

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Seventeen neonates and small children underwent the operation of wedge excision spinal osteotomy for the correction of gross kyphosis. The operation involved massive blood loss, exceeding 50 per cent of estimated blood volume in all patients, and exceeding 150 per cent in two, with no operative mortality. The anaesthetic technique and management of massive blood replacement in these cases is described. The general problems associated with massive blood transfusion in small subjects are reviewed and discussed. Maintenance of normothermia, and replacement of measured loss with warmed fresh blcod with buffering of the acid load are amongst the main recommendations.

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Hemorrhage and Transfusion as the Major Cause of Cardiac Arrest

Cited by 50 publications

References 7 publications

Massive Transfusion and Its Influence on Oxygen Transport and Electrolyte Balance

Massive Transfusion and Its Influence on Oxygen Transport and Electrolyte Balance

Blood Replacement

Massive Blood Replacement in Neonates and Children

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