Massive transfusion..Hypo or hyper kalemia

Massive transfusion associated with many hazards.

One of these hazards is electrolytes distrubances,which include hypocalcemia and hypomagnesemia.Potassium has 2 different routes in massive transfusion,it my end up in hyperkalemia or more commonly in hypokalemia.

Plasma potassium levels rise by approximately one mEq/L per day in stored blood due to leakage out of red cells. Although one unit contains a very small amount of potassium as most of the plasma is removed, in the hypoperfused, acidotic shock state hyperkalemia may become an issue.

Hypokalemia is actually a more common occurrence with large volume transfusion because the large volumes of citrate are metabolized to bicarbonate causing a metabolic alkalosis.

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