title: Intraoperative hypokalemia in pediatric liver transplantation: incidence and risk factors.
abstract: In this retrospective study of 268 children undergoing liver transplantation, we investigated the incidence of intraoperative potassium (K+) disturbances and the risk factors for hypokalemia in the preperfusion and postreperfusion periods. Overall, hypokalemia was the predominant disturbance, occurring in 72.0% of pediatric patients during liver transplantation. Hypokalemia was more common during the postreperfusion period than the prereperfusion period. Hyperkalemia, though a commonly cited complication, was infrequent during pediatric liver transplantation. Using multivariate logistic regression analysis, baseline serum K+ < or =3.5 mmol/L, base excess >5 mmol/L, and creatinine < or =0.5 mg/dL were found to be predictors for hypokalemia in the prereperfusion period; and body weight < or =15 kg, K+ < or =3.5 mmol/L, fresh-frozen plasma transfusion >90 mL/kg, and absence of ascites at surgery were independent predictors for hypokalemia in the postreperfusion period. These findings support the use of K+ replacement to maintain normokalemia and avoid the potential complications related to hypokalemia in pediatric liver transplantation, especially in children with the risk factors for hypokalemia.
authors.affiliation: Department of Anesthesiology, David Geffen School of Medicine, University of California, Los Angeles, California 90095-1778, USA. vxia@mednet.ucla.edu
authors.forename: Victor W
authors.initials: VW
authors.lastname: Xia
authors.forename: Bin
authors.initials: B
authors.lastname: Du
authors.forename: Albert
authors.initials: A
authors.lastname: Tran
authors.forename: Luke
authors.initials: L
authors.lastname: Liu
authors.forename: Ke-Qin
authors.initials: KQ
authors.lastname: Hu
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Hiatt
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Busuttil
authors.forename: Randolph H
authors.initials: RH
authors.lastname: Steadman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007008:Hypokalemia / Q000453:epidemiology* / Q000209:etiology* / Q000378:metabolism; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications; D016031:Liver Transplantation / Q000379:methods*; D015999:Multivariate Analysis; D011188:Potassium / Q000378:metabolism*; D015424:Reperfusion; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D011188:Potassium