Dietary citrate and plasma ionized calcium: Implications for platelet donors.

Autor: Haynes S; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Hickson E; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Linden J; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., St Pierre P; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Ducharme P; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Sulmasy P; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Welch L; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Zhao Y; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.; Division of Transfusion Medicine, University of Mass Memorial Medical Center, Worcester, Massachusetts.; Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.; Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts., Greene M; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Vauthrin M; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts., Weinstein R; Transfusion Medicine and Apheresis Service, UMass Memorial Medical Center, Worcester, Massachusetts.; Division of Transfusion Medicine, University of Mass Memorial Medical Center, Worcester, Massachusetts.; Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.; Department of Pathology, University of Massachusetts Medical School, Worcester, Massachusetts.
Jazyk: angličtina
Zdroj: Journal of clinical apheresis [J Clin Apher] 2018 Jun; Vol. 33 (3), pp. 222-225. Date of Electronic Publication: 2017 Aug 12.
DOI: 10.1002/jca.21575
Abstrakt: Background: Platelet donors receive 40 mmol or more of IV citrate anion during donation. When plasma ionized calcium ([Ca 2+ ]) falls by ∼20%, half of the donors report symptoms of hypocalcemic toxicity. Citrus juices contain clinically relevant amounts of citrate anion. We asked whether citrus juice can lower [Ca 2+ ] thus potentially contributing to hypocalcemic toxicity.
Method: Six volunteers were given 20.4 mmol of citrate anion as grapefruit juice or orange juice. Capillary blood obtained by fingerstick was analyzed for [Ca 2+ ] using an iSTAT point-of-care blood analyzer. [Ca 2+ ] was measured at baseline and then 30, 60, 120, and 180 minutes after drinking juice. Subjects were tested with the alternative juice on a subsequent day. The outcome measure was the percent change in plasma [Ca 2+ ] from baseline.
Results: [Ca 2+ ] fell -2.2% to -11.5% in four of six subjects 30 minutes after drinking grapefruit juice. The effect persisted up to 3 hours. [Ca 2+ ] fell -2.1% to -12.2% in four of six subjects 30-60 minutes after drinking orange juice. The effect abated after 2 hours. We could not correlate gender or body surface area to these findings.
Summary and Conclusions: Citrus juice may lower [Ca 2+ ] for 2-3 hours. This could add to the effect of IV citrate infusion during platelet donation, thus worsening the expected fall in [Ca 2+ ]. This, in turn, would likely increase the rate and severity of hypocalcemic toxicity. It is prudent to advise platelet donors to avoid high citrate anion beverages, such as citrus juice, for at least 4 hours prior to donation.
(© 2017 Wiley Periodicals, Inc.)
Databáze: MEDLINE
Externí odkaz: