Prospective study of potassium-associated acute transfusion events in pediatric intensive care
Bibliographic record
Abstract
OBJECTIVE: Transfusion of packed red blood cells containing high concentrations of potassium have been associated with fetal and neonatal arrhythmia and hyperkalemic cardiac arrest. This study sought to determine the biochemical and associated clinical effects of packed red blood cells transfusion in critically ill children. DESIGN: Prospective case series. SETTING: Tertiary multidisciplinary university hospital pediatric intensive care unit. PATIENTS: Consecutive sample of 28 children 2.7-27 kg (1 wk to 12 yrs old) receiving a packed red blood cell transfusion. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Potassium concentration was prospectively measured from packed red blood cell transfusions. Adverse events were recorded during and for 4 hrs following transfusion including hyperkalemia, therapy for hyperkalemia, arrhythmia, cardiac arrest, and death. There were 54 packed red blood cell transfusions (mean volume of 11.8 +/- 2.8 mL/kg). The measured packed red blood cell potassium concentration was > 25 mmol/L in 16, 15-25 mmol/L in 11, and < 15 mmol/L in 25. The mean patient potassium concentrations before (3.85 +/- 0.55, range 2.7-5.2 mmol/L) and after transfusion (3.94 +/- 0.62, range 2.8-5.7 mmol/L) were not significantly different. There was no therapy required for hyperkalemia, no new arrhythmia, no cardiopulmonary arrest, and no deaths during and up to 4 hrs following transfusion. Of the six children given a bolus of packed red blood cells (> or = 5 mL/kg over < 10 mins), the maximum increase in patient potassium concentration was 0.8 mmol/L, in a child who had an initial potassium concentration of 2.7 mmol/L. No patient's potassium concentration was > 5 mmol/L following rapid transfusion. CONCLUSIONS: This prospective study found no significant change in patient potassium concentration and no acute adverse events related to transfusion in critically ill children, including those receiving packed red blood cells by bolus. Larger prospective studies are required to evaluate the acute effects of rapid and central venous transfusion in critically ill children.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".