Quantitative assessment of infusion pump-mediated haemolysis in feline packed red blood cell transfusions

2021 ◽  
pp. 1098612X2199999
Author(s):  
Carles Blasi-Brugué ◽  
Ignacio M Sanchez ◽  
Rui R F Ferreira ◽  
Augusto J F de Matos ◽  
Rafael Ruiz de Gopegui
Keyword(s):  
Blood Cells ◽  
Quantitative Assessment ◽  
Infusion Pump ◽  
Administration System ◽  
Packed Red Blood Cells ◽  
Friedman's Test ◽  
Long Time ◽  
Red Blood Cell Transfusions ◽  
Total Haemoglobin ◽  
Infusion System

Objectives Haemolysis caused by the use of peristaltic infusion pumps (PIPs) has been described in human and canine packed red blood cells (pRBCs). The aim of this study was to evaluate the effects of two different linear PIPs on the haemolysis of feline pRBC units stored for a long time. Methods Feline pRBC units stored with adenine, dextrose, mannitol and sodium chloride (SAGM) were manufactured. After 35–42 days of storage at 2–4°C, a line administration system with a 180 µm filter was attached to every pRBC bag, the system was drained by gravity alone (8 drops/min) and a 1.3 ml sample was collected (G). A NIKI V4 pump was then used at a flow rate of 25 ml/h, the flow was stopped when the infusion system was filled with blood coming from the infusion pump and another 1.3 ml sample was collected (NK). Finally, an Infusomat FmS pump was evaluated, collecting another 1.3 ml sample (IM). Packed cell volume (PCV) was measured in all samples by microhaematocrit centrifugation, total haemoglobin (HGB) was measured using a specific haemoglobin analyser and, after centrifugation, free HGB was determined by spectrophotometry. The percentage of haemolysis was calculated. Friedman’s test was used to compare the samples. Results Fifteen feline pRBC units were evaluated. The average degree of haemolysis for sample G (gravity-assisted) was 1.12%. Comparison of the degree of gravity-assisted haemolysis with haemolysis in PIP NK (1.13%) and IM (1.14%) samples revealed no significant differences, with differences of only 0.01% and 0.02%, respectively. Conclusions and relevance The results of this study demonstrate that the use of two common PIPs in veterinary hospitals does not produce levels of haemolysis that are significantly different than that caused by gravity alone during transfusion of feline pRBCs at a rate of 25 ml/h.

7. Epilogue: the future of blood

2016 ◽  
pp. 124-130
Author(s):  
Chris Cooper
Keyword(s):  
Stem Cell ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Blood Cells ◽  
Blood Substitute ◽  
Liquid Form ◽  
Blood Typing ◽  
Cell Technology ◽  
Long Time ◽  
Red Blood Cell Transfusions

For a long time, synthetic biologists have attempted to manufacture an artificial, easily stored and transported, blood substitute that does not require blood typing, is long lasting, and can be guaranteed pathogen free. Three different methods have been attempted to replace red blood cell transfusions: the use of perfluorocarbons, inert chemicals that, in liquid form, can dissolve gases without reacting with them; creating a haemoglobin-based blood substitute—but despite almost a billion dollars of research and development there is not one in general use today; and growing artificial red blood cells using stem cell technology—but doing this safely, reproducibly, and in large amounts is a huge bioengineering challenge.

STUDIES OF SHOCK PRODUCED BY MUSCLE TRAUMA: I. METHODS; MORTALITY; CARDIOVASCULAR, BLOOD CONCENTRATION, AND SUGAR CHANGES

1944 ◽  
Vol 22e (1) ◽  
pp. 12-25 ◽  
Author(s):  
R. A. Cleghorn ◽  
A. D. McKelvey
Keyword(s):  
Blood Pressure ◽  
Blood Sugar ◽  
Blood Cells ◽  
Blood Substitute ◽  
Great Majority ◽  
Fluid Loss ◽  
Packed Red Blood Cells ◽  
Muscle Trauma ◽  
Long Time ◽  
Severe Shock

A large series of dogs, subjected to severe muscle trauma, has been studied. Eighty-four per cent died or would have died of shock within 24 hr. had they not been treated with a blood substitute. Of these about half developed severe shock in less than five hours. A few, 3.7% of the series, died between 24 and 80 hr., and 12.3% were considered indefinite survivors either being well when killed at 24 hr. or appearing well at the end of three days after trauma.Repeated observations made on the blood pressure and heart rate made it possible to predict death some time in advance in a great majority of cases. Haemoconcentration, as evidenced by an increase in the volume of packed red blood cells, occurred in the majority of the animals. This is ascribed partly to the fact that the fluid loss into the damaged tissues was principally plasma rather than whole blood, and partly to the fact that the animals were not deeply anaesthetized for a long time and consequently reflex splenic contraction added cells to the circulation. The blood sugar in dogs dying within three hours of trauma was normal or elevated. In dogs dying later it was often low. In those in which life was prolonged a few hours by a blood substitute the terminal value was very low. In many dogs in which life was prolonged beyond 24 hr. the blood sugar values slightly before death were within normal limits.The significance of these findings is discussed.

Administration of whole blood, packed red blood cells, and platelets using a multipurpose infusion pump

1991 ◽  
Vol 48 (9) ◽  
pp. 1970-1972
Author(s):  
Andy H. Strayer ◽  
David W. Henry ◽  
Allen Erenberg ◽  
Richard D. Leff
Keyword(s):  
Red Blood Cells ◽  
Whole Blood ◽  
Blood Cells ◽  
Infusion Pump ◽  
Packed Red Blood Cells

scholarly journals Hemolysis risk after packed red blood cells transfusion with infusion pumps

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Ana Maria Miranda Martins Wilson ◽  
Maria Angélica Sorgini Peterlini ◽  
Mavilde da Luz Gonçalves Pedreira
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Infusion Pump ◽  
Randomized Study ◽  
Transfusion Practice ◽  
Free Hemoglobin ◽  
Infusion Pumps ◽  
Packed Red Blood Cells ◽  
Total Hemoglobin ◽  
Before And After

ABSTRACT Objective: To evaluate the hemolysis biomarkers of packed red blood cells transfused by two different linear peristaltic infusion pumps at two infusion rates. Method: An experimental and randomized study was designed simulating the clinical practice of transfusion. Two linear peristaltic infusion pumps from different manufactures were studied in triplicate at 100 mL/h and 300mL/h infusion rates. The chosen hemolysis biomarkers were total hemoglobin, free hemoglobin, hematocrit, potassium and degree of hemolysis. They were analyzed before and after each infusion. Results: Potassium showed statistically significant variations in all scenarios of the experiment (P<0.010). In a separated analysis, potassium increased mainly at 300mL/h rate (P=0.021) and free hemoglobin had significant variation when comparing infusion pumps from different manufacturers (P=0.026). Although hematocrit, total hemoglobin and degree of hemolysis had increased after infusion, no statistically significance variations were identified. Conclusions: Hemolysis risk induced by a linear peristaltic infusion pump was identified by an increase in free hemoglobin and potassium markers. As the potassium biomarker is often increased in aged packed red blood cells, we do not recommend using them in this scenario. Additional studies should be performed about other markers and using larger samples in order to reinforce the transfusion practice in nursing.

Endogenous Heparinoids Detected by anti-Xa Activity are Present in Blood during Acute Variceal Bleeding in Cirrhosis. A Prospective Study

2014 ◽  
Vol 23 (2) ◽  
pp. 187-194 ◽  
Author(s):  
Christos Triantos ◽  
Emmanuel Louvros ◽  
Maria Kalafateli ◽  
Anne Riddell ◽  
Ulrich Thalheimer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Variceal Bleeding ◽  
Blood Cells ◽  
Venous Pressure ◽  
White Blood Cells ◽  
International Normalized Ratio ◽  
Ulcer Bleeding ◽  
Factor X ◽  
Packed Red Blood Cells ◽  
Bacterial Peritonitis

Background & Aims: Endogenous heparinoids have been detected by thromboelastography and quantified by clotting based anti-Xa activity assays in patients with cirrhosis, but their presence in variceal bleeding has not been established yet.Methods: Clotting based anti-Xa activity was measured in A) 30 cirrhotics with variceal bleeding, B) 15 noncirrhotics with peptic ulcer bleeding, C) 10 cirrhotics without infection or bleeding, and D) 10 cirrhotics with hepatocellular carcinoma (HCC).Results: Anti-Xa activity was not detected in ulcer bleeders or in cirrhotics without infection or bleedingbut was present in seven (23%) variceal bleeders (median levels: 0.03 u/mL (0.01-0.07)) and was quantifiable for 3 days in six of seven patients. Four of seven variceal bleeders with anti-Xa activity present had HCC (p=0.023). Age, creatinine, platelet count and total infections the second day from admission were significantly correlated with the presence of measureable anti-Xa levels (p=0.014, 0.032, 0.004 and 0.019, respectively). In the HCC group, anti-Xa activity was present in three patients (30%) [median levels: 0.05 u/mL (0.01-0.06)].Conclusions: In this study, variceal bleeders and 30% of the patients with HCC had endogenous heparinoids that were detected by a clotting based anti-Xa activity assay, whereas there was no anti Xa activity present in patients with cirrhosis without infection, or bleeding or HCC, nor in those with ulcer bleeding. Thus, the anti-Xa activity is likely to be a response to bacterial infection and/or presence of HCC in cirrhosis.List of abbreviations: AFP, alpha-fetoprotein; aPTT, activated partial thromboplastin time; CP, Child-Pugh; FXa, activated factor X; GAGS, glycosaminoglycans; Hb, hemoglobin; HCC, hepatocellular carcinoma; HVPG, hepatic venous pressure gradient; INR, International normalized ratio; LMWHs, low molecular weight heparins; MELD, Model for End-stage Liver Disease; PPP, platelet-poor plasma; PRBC, packed red blood cells; PT, prothrombin time; SBP, sponataneous bacterial peritonitis; TEG, thromboelastography; WBC, white blood cells.

scholarly journals Blood Donations and Transfusions during the COVID-19 Pandemic in Spain: Impact According to Autonomous Communities and Hospitals

2021 ◽  
Vol 18 (7) ◽  
pp. 3480
Author(s):  
José Antonio García-Erce ◽  
Íñigo Romón-Alonso ◽  
Carlos Jericó ◽  
José María Domingo-Morera ◽  
José Luis Arroyo-Rodríguez ◽  
...  
Keyword(s):  
Blood Cells ◽  
Blood Components ◽  
Health Ministry ◽  
State Of Emergency ◽  
Blood Donations ◽  
Autonomous Communities ◽  
Packed Red Blood Cells ◽  
Average Decrease ◽  
A Prospective Study ◽  
The Impact

Worldwide, the COVID-19 pandemic has caused a decline in blood donations, between 30% and 70% in some of the most affected countries. In Spain, during the initial eight weeks after the State of Emergency was decreed on 14 March 2020, in the weekly reports of the Health Ministry, an average decrease of 20% was observed between 11 and week 25 compared with the 2018 donation. We aimed to investigate the impact of the COVID-19 pandemic on blood donations and blood distribution in four autonomous communities, and to explore the evolution of the consumption of blood components (BCs) in ten hospitals of six autonomous communities. We performed a prospective study of grouped cohorts on the donation and distribution of blood in four regional transfusion centers in four autonomous communities in Spain, and a retrospective study of the consumption of blood components in ten hospitals in six autonomous communities. Regarding donations, there was no significant decrease in donations, with differences between autonomous communities, which started between 1 and 15 March 2020 (−11%). The increase in donations in phase II (from 26 May 2020) stands out. Regarding consumption, there was a significant reduction in the consumption of packed red blood cells (RBCs) (24.5%), plasma (45.3%), and platelets (25.3%) in the central period (16 March–10 May). The reduction in the consumption of RBCs was significant in the period from 1–15 March. Conclusions: The COVID-19 pandemic has affected the donation and consumption of BCs.

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