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Cardiovascular depression secondary to ionic hypocalcemia during hepatic transplantation in humans

Marquez, J and Martin, D and Virji, MA and Kang, YG and Warty, VS and Shaw, B and Sassano, JJ and Waterman, P and Winter, PM and Pinsky, MR (1986) Cardiovascular depression secondary to ionic hypocalcemia during hepatic transplantation in humans. Anesthesiology, 65 (5). 457 - 461. ISSN 0003-3022

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Cardiovascular function, serum ionized calcium (Ca2+), and serum citrate were measured intraoperatively in patients (n = 9) undergoing orthotopic hepatic homotransplantation. Serum citrate increased 20-fold (P < 0.0006) following transfusion of citrated blood products in the absence of a functional liver. Serum ionized calcium decreased (P < 0.003) with concomitant decreases in cardiac index (P < 0.005), stroke index (P < 0.004), and left ventricular stroke work index (P < 0.001). Hemodynamic depression and ionic hypocalcemia were reversed following the administration of CaCl2. In contrast to patients with normal hepatic function, who may tolerate large amounts of citrated blood, patients with end-stage liver disease demonstrate acute ionic hypocalcemia with concomitant hemodynamic depression when receiving citrated blood products during the course of hepatic transplantation.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Marquez, J
Martin, D
Virji, MAvirjim@pitt.eduVIRJIM
Kang, YG
Warty, VS
Shaw, B
Sassano, JJ
Waterman, P
Winter, PM
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 January 1986
Date Type: Publication
Journal or Publication Title: Anesthesiology
Volume: 65
Number: 5
Page Range: 457 - 461
DOI or Unique Handle: 10.1097/00000542-198611000-00001
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0003-3022
MeSH Headings: Blood Transfusion--adverse effects; Calcium Chloride--therapeutic use; Cardiovascular System--physiopathology; Citrates--adverse effects; Citrates--blood; Depression, Chemical; Humans; Hypocalcemia--chemically induced; Hypocalcemia--drug therapy; Hypocalcemia--physiopathology; Ions; Liver Diseases--surgery; Liver Transplantation
PubMed ID: 3535571
Date Deposited: 25 Aug 2012 17:24
Last Modified: 22 Jun 2021 13:56


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