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Canadian Journal of Anesthesia 47:792-795 (2000)
© Canadian Anesthesiologists' Society, 2000
Clinical Report

Management of prolonged QT interval during a massive transfusion: calcium, magnesium or both?

Andrew Meikle, MD and Brian Milne, MD FRCP

From the Department of Anesthesia, Queen's University, Kingston, Ontario, Canada.

Address correspondence to: Dr. Andrew Meikle, Department of Anesthesia, Kingston General Hospital, 76 Stuart Street, Kingston, Ontario, K7L 2V7 Canada. Phone: 613-548-7827; Fax: 613-548-1375; E-mail: andy_meikle{at}hotmail.com

Objectif : L'observation suivante décrit le traitement peropératoire d'un intervalle QT prolongé dans le cadre d'une transfusion massive.

Éléments cliniques : Un homme de 45 ans, auparavant en bonne santé, a été admis pour la réparation d'un anévrisme thoraco-abdominal de classe IV. L'opération se déroulait sans incident, sauf pour une perte sanguine d'environ 5,0 L. Puis, l'intervalle QT s'est allongé de façon marquée pour ensuite se rétrécir, en réponse au calcium et au magnésium thérapeutiques. L'analyse de sang prélevé juste avant la prolongation QT a révélé la présence de calcium ionisé à 0,98 mmol•L-1 et de magnésium ionisé à 0,37 mmol•L-1, ce qui pouvait indiquer que le bas taux de magnésium avait contribué à la prolongation de l'intervalle QT.

Conclusion : Ce cas illustre l'importance de tester le calcium et le magnésium ionisé au cours du traitement d'une transfusion massive.




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This Article
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