Complication of massive blood transfusion?
Correct Answer: Hyperkalemia
Description: Ans is 'c' i.e. Hyperkalemia * The potassium concentration of blood increases during storage & massive transfusion of units containing increased potassium may lead to hyperkalemia - adding to elevated potassium levels caused by severe shock, renal dysfunction and muscle necrosis.Massive blood transfusion* A massive blood transfusion is defined as the replacement of a patient's total blood volume in <24 h which is generally described as transfusion of >10 units of blood products (specifically Packed red blood cells within a 24-hour period)* Hemorrhagic shock is the only indication for a massive transfusion* The greatest concern during MTP is the lethal triad:i) Hypothermiaii) Coagulopathy (dilutional)iii) Acidosis (Lactic acidosis from inability to breakdown citrate secondary to hepatic dysfunction)Other complication include1) Hypocalcemia and hypomagnesemia from high citrate concentration2) Hyperkalemia3) Air embolism4) Metabolic alkalosis from breakdown of citrate5) Paradoxical hypokalaemia6) Metabolic alkalosis7) Transfusion-associated acute lung injury8) Transfusion reactions such as ABO incompatibility, anaphylaxis, febrile non-haemolytic reactions9) Infectionsa) HIV / AIDS, hepatitis, vCJD, HTLV, malaria, CMVb) sepsis / septicaemia10) Fluid overload and acute pulmonary oedema (APO)11) Transfusion-associated graft vs host disease12) DIC
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