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Processing of stored packed red blood cells using autotransfusion devices decreases potassium and microaggregates: a prospective, randomized, single‐blinded in vitro study
Author(s) -
WestphalVarghese B.,
Erren M.,
Westphal M.,
Van Aken H.,
Ertmer C.,
Lange M.,
Booke M.
Publication year - 2007
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/j.1365-3148.2007.00732.x
Subject(s) - autotransfusion , cats , medicine , electrolyte , potassium , anesthesia , packed red blood cells , red blood cell , saline , surgery , blood transfusion , andrology , chemistry , organic chemistry , electrode
summary The aim of the study was to compare the potential of autotransfusion devices to reduce non‐infectious complications related to transfusion of long‐stored packed red blood cells (PRBC; n = 57), such as changes in electrolytes, blood cells and the load of free microaggregates. Following a baseline measurement, a blood pool of three PRBC was divided into three equal volumes and washed with either the Haemonetics Cell Saver™ (HCS) or the continuous autotransfusion system (C.A.T.S™), using the quality (CATS quality ) and emergency (CATS emergency ) mode. After the washing procedure, measurements for electrolytes, blood cells and free microaggregates were repeated ( n = 19 each). Compared with baseline, the investigated autotransfusion devices reduced the median load of potassium (baseline: 52 mEq L −1 ; HCS: 4 mEq L −1 ; CATS quality : 4 mEq L −1 ; CATS emergency : 17 mEq L −1 ; each P < 0·001), restored a physiologic electrolyte balance and significantly decreased the load of leucocytes, glucose and protein. Whereas the quantity of microaggregates was not reduced by HCS, CATS emergency decreased the load of cell fragments below 7·8 μm ( P < 0·05 vs. baseline). Using CATS quality decreased the load of cell fragments not only to a diameter below 7·8 μm ( P < 0·001 vs. baseline) but also of microaggregates between 7·8 and 17·6 μm ( P < 0·05 vs. baseline). In situations where long‐stored PRBC have to be transfused, the procedure described here may be feasible to reduce clinically relevant side effects, i.e. hyperkalaemia and microvascular obstruction secondary to free cell fragments. This approach could be especially useful in patients undergoing massive transfusion and/or suffering from renal failure.