Abstract

大量出血に対し, 照射MAP加赤血球濃厚液急速投与を行ったところ, 高カリウム血症から心停止に至った症例を経験した. 症例は68歳, 女性. 大量出血による血圧低下のため, 輸血速度を80ml/minに速めたところ, 心電図上QRS幅の延長に引き続き心停止に至った. ただちに胸骨圧迫心マッサージを行い, 塩化カルシウムと炭酸水素ナトリウムの投与で洞調律に復帰した. 心停止直前の血清K値は8. 3mEq/Lであった. 投与したMAP血のK値は45mEq/L (照射後11日) であったため, 以後の赤血球輸血には自己血回収装置 (Cell Saver) を用いて照射血を生理食塩水で洗浄したものを用いた. Cell Saverにより作製した洗浄照射赤血球の輸血は, 高カリウム血症の回避に有効であった.

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