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Coinfusion of dextrose‐containing fluids and red blood cells does not adversely affect in vitro red blood cell quality
Author(s) -
Keir Amy K.,
Hansen Adele L.,
Callum Jeannie,
Jankov Robert P.,
Acker Jason P.
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12618
Subject(s) - hemolysis , hematocrit , saline , red blood cell , mean corpuscular volume , andrology , hemoglobin , incubation , potassium , chemistry , medicine , zoology , anesthesia , biology , biochemistry , organic chemistry
Background Transfusion guidelines advise against coinfusing red blood cells ( RBC s) with solutions other than 0.9% saline. We evaluated the impact of coinfusion with dextrose‐containing fluids ( DW ) on markers of RBC quality. Study Design and Methods A pool‐and‐split design was used to allow conditions to be tested on each pool within 2 hours of irradiation. Three pools at each storage age (5, 14, and 21 days) were created for each phase. In Phase 1, samples were infused through a neonatal transfusion apparatus alone or with treatment solutions: D 5 W , D 10 W , D 5 W /0.2% saline, and 0.9% saline. In Phase 2, samples were incubated alone or in a 1:1 ratio with treatment solutions and tested after 5, 30, and 180 minutes. Hemolysis, supernatant potassium, RBC indices, morphology, and deformability were measured on all samples. Results In Phase 1, RBC s transfused alone through the apparatus had higher (p < 0.01) hematocrit, total hemoglobin, and supernatant potassium compared to all other groups. No statistical differences were identified between groups for other measured variables. In Phase 2, mean corpuscular volume of all samples containing DW increased with incubation length and were higher (p < 0.01) than RBC s incubated alone or with 0.9% saline after 30 and 180 minutes. RBC s incubated with D 5 W and D 5 W /0.2% saline had greater (p < 0.05) hemolysis than RBC s alone after 180 minutes. Conclusion In vitro characteristics of RBC s coinfused with 0.9% saline or D 10 W were not adversely impacted. When developing clinical studies in neonates, we recommend use of D 10 W and a transfusion apparatus that minimizes the contact volume of the coinfusate with the RBC .