This paper describes a simple device for removing excess potassium and ammonium ions from bank blood during transfusion.
A progressive rise in the concentration of potassium and ammonium occurs in whole blood during storage.1-3 This takes place regardless of the original method of collection.3 During most transfusions, excessive potassium and ammonium in bank blood are diluted by the patient's blood, and thus are well tolerated. However, when large volumes of blood are needed rapidly to combat oligemia, the effect from elevated levels of these electrolytes becomes increasingly hazardous.
Keith and Osterberg4 reported marked intolerance to exogenous potassium in patients with advanced renal insufficiency. During the Korean War, studies on renal failure following severe wounding revealed that the hyperkalemia resulting from extensive tissue destruction was greatly aggravated because of multiple transfusions with old bank blood.5 Some cardiac arrhythmias during massive blood replacement may be on the basis