| Change of Ionized Calcium following Blood Transfusion during Hepatic Lobectomy. |
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Gyu Wan Kim, Chee Mahn Shin, Joo Yuel Park |
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Department of Anesthesiology, Pusan Paik Hospital, Inje University, Pusan, Korea. |
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| Abstract |
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Citrate in transfused blood forms a complex with calcium and decreases the free ionized calcium. Serum normalized ionized calcium(nCa2+) concentration was measured in patients receiving resection of brain tumor(Group l) and hepatic lobectomy(Group 2) before and after transfusion The results were as follows; l) nCa2+ concentration decreased from 1.08+/-0.08 mmol/L at baseline to 0.98+/-0.10 mmol/L(p< 0.05) at 10 min after transfusion in Group l. 2) nCa2+ concentration decreased from 1.13+/-0.05 mmol/L at baseline to 0.84+/-0.08 mmol/L(p< 0.01) at 10min and to 0.87+/-0.11 mmol/L(p<0.05) at 2hr after transfusion in Group 2. 3) nCa2+ concentration at 10 min and 2hr after transfusion in Group 2 were significantly lower than those in Group l(p<0.05).
nCa2+ concentration decreased significantly after transfusion and didnt returned to baseline at 2hr after transfusion during hepatic lobectomy. We conclude that it is essential to measure ionized calcium(Ca2+) concentration directly and at frequent interval during transfusion in hepatic surgery and we can prevent or treat severe hypocalcemia and cardiovascular depression with measured serum Ca2+. |
| Key Words:
Transfusion; Citrate; Calcium |
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