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Unexpected Citrate Toxicity and Severe Hypocalcemia During Apheresis by L. Uhl; S. Maillet; S. King; M. S. Kruskall is a Medicine article available to read on EtoBox.

The citrate anticoagulant used during apheresis procedures is considered a safe medication because it is rapidly metabolized by the donor. However, acute, life-threatening hypocalcemia is possible if the infusion rate.of citrate is increased. , CASE REPORT A 54-year-old woman with metastatic breast cancer, but otherwise in good health, had just begun a fifth collection of hematopoietic peripheral blood progenitor cells by leukapheresis. The instrument's selfloading apheresis kit was primed uneventfully. Seven minutes into the procedure, the patient developed signs and symptoms suggesting severe hypocalcemia, including muscle spasms, chest pain, and hypotension. The citrate bag was discovered to have emptied, and a section of the anticoagulant tubing was protruding outside of the rotary pump. The patient's ionized calcium'level was 0.64 mmol per L (normal range, 1.18-1 38 mmoi/L). In subsequent experiments where the anticoagulant tubing was either improperly loaded at the outset or partially pulled out of'the rotary pump, no instrument alarms sounded. CONCLUSION: ,Citrate toxicity and life-threatening hypocalcemia can occur if the anticoagulant line of an aptieresis instrument is no

It is typically read by researchers, students, and practitioners in Medicine.

Author
L. Uhl; S. Maillet; S. King; M. S. Kruskall
Publisher
Elsevier Science; John Wiley and Sons; Wiley (Blackwell Publishing); Blackwell Publishing Inc.; Elsevier; Elsevier BV; Wiley (ISSN 0372-1248)
Published
1997
Language
EN
Field
Medicine (Health Sciences)