title: Effects of liver function on ionized hypocalcaemia following rapid blood transfusion.
abstract: OBJECTIVE
  Hypocalcaemia detrimentally affects the cardiovascular system and massive transfusion-related hypocalcaemia is particularly severe in end-stage liver disease patients undergoing liver transplantation (LT). This study, therefore, compared the severity and duration of ionized  hypocalcaemia between patients with normal and impaired liver function.
  
  
  METHODS
  Patients (n = 26 per group) were transfused at a rate of 10 ml/kg within 10 min with packed red blood cells (PRBCs) during LT (group LP) or spinal surgery (group SP), or were infused with 0.9% normal saline  during spinal surgery (group SN). Serum levels of ionized calcium were assessed before (T(0)), just after (T(1)), and at 20 (T(2)) and 60 min (T(3)) after transfusion.
  
  
  RESULTS
  Transfusion with PRBCs caused more severe ionized hypocalcaemia than 0.9% normal  saline at T(1). In contrast to the faster (20 min) normalization in group SP, ionized hypocalcaemia in group LP persisted at T(3). Serum ionized calcium levels at T(3) showed correlations with vital signs, blood glucose, serum potassium, base deficit and lactate.
  
  
  CONCLUSIONS
  Rapid blood transfusion caused more severe and prolonged ionized hypo calcaemia in patients with liver dysfunction than in those with normal liver function.
authors.affiliation: Department of Anaesthesia and Pain Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Chung
authors.forename: S J
authors.initials: SJ
authors.lastname: Cho
authors.forename: C S
authors.initials: CS
authors.lastname: Park
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001803:Blood Transfusion; D002118:Calcium / Q000097:blood*; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000097:blood* / Q000378:metabolism; D019344:Lactic Acid / Q000097:blood; D008099:Liver / Q000378:metabolism*; D008111:Liver Function Tests; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood
chemical_list: D001786:Blood Glucose; D019344:Lactic Acid; D011188:Potassium; D002118:Calcium