Hypocalcaemia, hyperkalaemia and massive haemorrhage in liver transplantation

Rando, Karina; Vázquez, María; Cerviño, Gabriela; Zunini, Graciela

doi:10.1016/j.rcae.2014.04.003

Cited by 3 publications

(2 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 Differences in clinical significance between the trauma and perioperative populations are hypothesised to result from alterations in citrate clearance secondary to hypotension, acidosis, and hypothermia in the trauma cohort. 6 Recent studies on intraoperative and perioperative massive resuscitation have been limited to specific surgeries, such as abdominal aortic aneurysm, 8 placenta accreta, 9 or liver transplantation, 10 which may not be widely generalizable. The largest study in non-cardiac surgery patients found that transfusion with 5 or more units of red blood cells was associated with increased 30-day mortality and greater rate of postoperative complications, however, this study did not specifically characterise the incidence and risk factors for abnormalities, like hypocalcaemia, in the massive transfusion population.…”

Section: Introductionmentioning

confidence: 99%

“…The largest study in non-cardiac surgery patients found that transfusion with 5 or more units of red blood cells was associated with increased 30-day mortality and greater rate of postoperative complications, however, this study did not specifically characterise the incidence and risk factors for abnormalities, like hypocalcaemia, in the massive transfusion population. 11 Studies in the perioperative population are limited to nongeneralizable surgical sub-populations [8][9][10] or are not reflective of current clinical practice. 7 Furthermore, trauma may precipitate altered citrate metabolism, which limits generalizability between trauma and surgical populations.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Volume of packed red blood cells and fresh frozen plasma is associated with intraoperative hypocalcaemia during large volume intraoperative transfusion

Douville

Davis

Jewell

et al. 2021

Transfusion Medicine

View full text Add to dashboard Cite

Background: Severe hypocalcaemia is associated with increased transfusion in the trauma population. Furthermore, trauma patients developing severe hypocalcaemia have higher mortality and coagulopathy. Electrolyte abnormalities associated with massive transfusion have been less studied in the surgical population. Here, we tested the primary hypothesis that volume of packed red blood cells and fresh frozen plasma transfused intraoperatively is associated with lower nadir ionised calcium in the surgical population receiving massive resuscitation. Methods:We performed a retrospective observational study at an academic quaternary care centre to characterise hypocalcaemia following large volume (4 or more units packed red blood cells) intraoperative transfusion. We used multivariable linear regression to assess if volume of transfusion with packed red blood cells and fresh frozen plasma were independently associated with a lower ionised calcium. We then used multivariable logistic regressions to assess the association between ionised calcium and transfusion with: (i) mortality, (ii) acute kidney injury, and (iii) postoperative coagulopathy.Results: Hypocalcaemia following large volume resuscitation in the operating room is a very frequent occurrence (70% of cases). After controlling for demographic variables and intraoperative variables, the volume transfused intraoperative was independently associated with hypocalcaemia on multivariable linear regression.Hypocalcaemia, intraoperative transfusion of packed red blood cells, and intraoperative transfusion of fresh frozen plasma were not shown to be associated with clinical outcomes.Conclusions: Hypocalcaemia was associated with increased transfusion volume in this single-centre study. Unlike the trauma population, hypocalcaemia was not associated with increased mortality during surgical care. Our findings suggest that despite improved practice patterns of calcium supplementation, intraoperative hypocalcaemia occurs with relatively high frequency following large volume intraoperative transfusion.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Volume of packed red blood cells and fresh frozen plasma is associated with intraoperative hypocalcaemia during large volume intraoperative transfusion

Douville

Davis

Jewell

et al. 2021

Transfusion Medicine

View full text Add to dashboard Cite

show abstract

Ectopic Mineralization Following Liver Transplantation—Mechanisms, Risks, and Management: A Review

Radhakrishnan,

Martin,

Dhayanithy

et al. 2023

Springer Proceedings in Earth and Environmental Sciences

View full text Add to dashboard Cite

Epidural blockade during liver transplantation

Zhikharev¹,

Бушуев²,

Khasanov³

et al. 2022

Regional Anesthesia and Acute Pain Management

View full text Add to dashboard Cite

AIM: This study aimed to evaluate the efficacy and safety of epidural analgesia as a component of pain relief on orthotopic liver transplantation. MATERIALS AND METHODS: Forty-five patients who underwent orthotopic liver transplantation were examined. Epidural and opioid analgesics were used as a component of pain relief in groups 1 (n=24) and 2 (n=21), respectively. The following parameters were evaluated: intensity of postoperative pain, time of patient activation, incidence of postoperative nausea and vomiting, time of onset of enteral nutrition, restoration of bowel function, incidence of postoperative acute respiratory failure, need for opioid analgesics, and length of stay in the intensive care unit (ICU). RESULTS: Pain intensity and total postoperative need for tramadol and promedol were significantly lower in group 1 than in group 2. During the postoperative period, group 1 showed a decrease in postoperative nausea and vomiting, incidence of postoperative respiratory failure, and time spent in the ICU. No complications with the insertion and removal of the epidural catheter were observed. CONCLUSION: The use of epidural blockade for liver transplantation significantly reduces the severity of pain syndrome, accelerates the recovery of bowel function, and shortens the length of ICU stay. The use of EA reduces the risk of PONV during the use of opioid analgesics and causes an early start of enteral nutrition. Therefore, epidural analgesics can be used as a component of pain relief in patients undergoing orthotopic liver transplantation.

show abstract

Hypocalcaemia, hyperkalaemia and massive haemorrhage in liver transplantation

Cited by 3 publications

References 43 publications

Volume of packed red blood cells and fresh frozen plasma is associated with intraoperative hypocalcaemia during large volume intraoperative transfusion

Volume of packed red blood cells and fresh frozen plasma is associated with intraoperative hypocalcaemia during large volume intraoperative transfusion

Ectopic Mineralization Following Liver Transplantation—Mechanisms, Risks, and Management: A Review

Epidural blockade during liver transplantation

Contact Info

Product

Resources

About