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Mixing commonly used crystalloid solutions with red blood cells in five common additives does not negatively impact hemolysis, aggregometry, or deformability.
Yarnoff, Kristine; Dodd-O, Jeffrey M.
Afiliación
  • Yarnoff K; Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Dodd-O JM; Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Transfusion ; 60(12): 2991-3000, 2020 12.
Article en En | MEDLINE | ID: mdl-33032376
BACKGROUND: Literature is beginning to challenge the belief that it is unsafe to coinfuse red blood cells (RBCs) with solutions other than isotonic saline. We recently showed that additive-free RBCs tolerated coincubation with Plasma-Lyte or catecholamines dissolved in normal saline (NS), though 5% dextrose in water (D5W) promoted hemolysis. Herein, we evaluate the effect of coincubating crystalloids on additive-preserved RBC hemolysis, aggregation, and membrane deformability. STUDY DESIGN AND METHODS: RBCs were coincubated 5 minutes with plasma, NS, Plasma-Lyte, lactated Ringer's (LR) or D5W (1 mL PRBC +131.3 µL solution). Samples were then assessed for hemolysis (free hemoglobin), aggregation (critical shear stress [mPa]), and membrane deformability (elongation index [EI]). Significance (P ≤ .05) by t test or ANOVA with post-hoc Tukey-Kramer test. RESULTS: Additive-prepared RBCs coincubated with crystalloid instead of plasma demonstrated: (a) no increase in hemolysis as indicated by plasma free hemoglobin levels that is likely to be clinically relevant; (b) no increase, but in some cases a decrease, in aggregation as indicated by critical shear stress; and (c) in some combinations, a deterioration in deformability. When present, the deformability decrease was likely clinically insignificant in degree, and always returned to normal when the crystalloid was subsequently diluted out with plasma. CONCLUSION: Our data suggest that additive-prepared RBCs coincubated for 5 minutes with any of four common crystalloids demonstrate no clinically relevant increased lysis, increased aggregation, or decreased deformability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Electrólitos / Agregación Eritrocitaria / Deformación Eritrocítica / Eritrocitos / Soluciones Cristaloides Límite: Humans Idioma: En Revista: Transfusion Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Electrólitos / Agregación Eritrocitaria / Deformación Eritrocítica / Eritrocitos / Soluciones Cristaloides Límite: Humans Idioma: En Revista: Transfusion Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos