The potential for hypocalcemia among patients receiving large amounts of donated blood products over a short time period is due to the presence of the anticoagulant citrate in the bag that donated blood is collected to. Each unit of packed red cells for transfusion contains approximately 3 gm citrate.
Why do blood transfusions cause hypocalcemia?
The transfused citrate binds ionized calcium in the recipient, and the resultant hypocalcemia is thought to be most prominent after the transfusion of plasma and platelets, due to their high citrate concentration.
Can blood transfusions cause hypercalcemia?
Metabolic complications associated with blood transfusion during OLT include the following: Benzodiazepine-associated encephalopathy. Metabolic alkalosis. Hypercalcemia.
What causes hypocalcemia in trauma patients?
Conclusion: Hypocalcemia frequently occurs on arrival at the hospital in severe trauma patients, and colloid-induced hemodilution and severe shock and/or ischemia-reperfusion appear to be important causative factors.
Does bleeding cause hypocalcemia?
Hypocalcemia correlates with the extent of bleeding in patients with ICH. A low calcium level may be associated with a subtle coagulopathy predisposing to increased bleeding and might therefore be a promising therapeutic target for acute ICH treatment trials.
How much calcium is needed after a blood transfusion?
The liver converts citrate to bicarbonate, thereby releasing calcium ions to facilitate the clotting ability of the blood. However, a massive blood transfusion overwhelms this process. For this reason, calcium needs to be replaced to maintain an ionised calcium level of more than 1.1 mmol/L (NBA 2011).
What are the complications of blood transfusion?
Some of the most common complications in blood transfusions are listed below.
- Allergic Reactions. Some people have allergic reactions to blood received during a transfusion, even when given the right blood type. …
- Fever. Developing a fever after a transfusion is not serious. …
- Acute Immune Hemolytic Reaction.
Can blood transfusion cause metabolic acidosis?
In conclusion, there is an increase in carbon dioxide production as a result of citrate metabolism in non-massive, frequent blood transfusions; elevated carbon dioxide production causes intracellular acidosis; metabolic alkalosis + respiratory acidosis and electrolyte imbalance such as hypocalcemia, hypokalemia, …
What is considered a massive blood transfusion?
Massive transfusion, historically defined as the replacement by transfusion of 10 units of red cells in 24 hours, is a response to massive and uncontrolled hemorrhage.
Why is calcium gluconate given during blood transfusion?
Exchange transfusion of blood collected with acid-citrate-dextrose (ACD) containing bags may produce hypocalcaemia.To decrease the morbidity from chelation of divalent cations by citrate, routine administration of calcium gluconate during EBT was advocated,but tetany, convulsion and death may still occur when ACD blood …
What is a massive transfusion protocol?
“Massive Transfusion Protocol” (MTP) refers to rapid administration of large amounts of blood products (at least 6 units of PRBC) in fixed ratios (usually 1:1:1) for the management of hemorrhagic shock. Only a subset of patients with “massive transfusion” will receive a massive transfusion protocol.
How do you fix hypocalcemia?
In patients with acute symptomatic hypocalcemia, intravenous (IV) calcium gluconate is the preferred therapy, whereas chronic hypocalcemia is treated with oral calcium and vitamin D supplements.
What is a classic sign of hypocalcemia?
Symptoms of hypocalcemia most commonly include paresthesia, muscle spasms, cramps, tetany, circumoral numbness, and seizures.
What is the most common cause of hypocalcemia?
Hypoalbuminemia is the most common cause of hypocalcemia. Causes include cirrhosis, nephrosis, malnutrition, burns, chronic illness, and sepsis.