In a patient with severe polytrauma who has received 10 units of packed red blood cells, what metabolic and coagulation complication is commonly monitored and countered with fresh frozen plasma, platelets, and cryoprecipitate?
Answer and explanation
Correct answer: C. Trauma-induced coagulopathy and hypocalcemia (citrate toxicity)
- Step 1: Massive transfusion protocols deplete clotting factors and platelets while citrate preservative binds ionized calcium.
- Step 2: Patients develop trauma-induced coagulopathy, hypocalcemia, and hypothermia (the lethal triad), requiring balanced 1:1:1 transfusion ratios and calcium repletion.
Answer
Trauma-induced coagulopathy and hypocalcemia (citrate toxicity).
Why not the others: 'Severe hypercalcemia and hypokalemia' is incorrect because citrate causes hypocalcemia, and stored red cells release potassium leading to hyperkalemia; 'Metabolic alkalosis with hypernatremia' does not account for the major acute hemorrhagic risks; 'Polycythemia vera and thrombocytosis' is a myeloproliferative disorder.
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