Massive transfusion and hyperkalaemic cardiac arrest in craniofacial surgery in a child.
Hyperkalaemia is a recognised complication of massive blood transfusion. We present a case of hyperkalaemic cardiac arrest in a male infant of 12 months, who was undergoing craniofacial surgery for sagittal craniosynostosis. At the time of arrest the patient had received a massive transfusion of predominantly irradiated packed red cells over a two-hour period, and had a measured plasma potassium concentration of 10.1 mmol/l. Cardiopulmonary resuscitation was successful after 15 minutes. On the basis of our laboratory data and a review of the available literature, we recommend the use of fresh, non-irradiated packed red cells whenever possible in paediatric surgery.
Buntain
S G
SG
Department of Anaesthesia, Mater Misericordiae Hospital, Brisbane, Queensland.
Pabari
M
M
D003398:Craniosynostoses / Q000601:surgery*; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D006947:Hyperkalemia / Q000209:etiology*; D007223:Infant; D007431:Intraoperative Complications; D008297:Male; D065227:Transfusion Reaction