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Korean J Anesthesiol > Volume 25(6); 1992 > Article
Korean Journal of Anesthesiology 1992;25(6):1093-1099.
DOI: https://doi.org/10.4097/kjae.1992.25.6.1093   
Change of Ionized Calcium following Blood Transfusion during Hepatic Lobectomy.
Gyu Wan Kim, Chee Mahn Shin, Joo Yuel Park
Department of Anesthesiology, Pusan Paik Hospital, Inje University, Pusan, Korea.
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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