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Age of packed red blood cells and its influence on concentration of selected biochemical values


Authors: Uvízl Radovan;  Fritscherová Šárka;  Neiser Jan;  Šafránek Petr;  Adamus Milan
Authors‘ workplace: Klinika anesteziologie a resuscitace, Fakultní nemocnice Olomouc
Published in: Anest. intenziv. Med., 20, 2009, č. 5, s. 257-261
Category: Intensive Care Medicine - Original Paper

Overview

Objective:
Administration of blood transfusion is associated with risk and adverse effects. Large-volume transfusion can cause electrolyte and acid-base balance disturbances. The influence of metabolism and decomposition of erythrocytes in the transfusion unit can change the initial values of some biochemical parameters; the age of the transfusion unit may play the major role. The aim of this study was to describe the influence of the age of the transfusion unit of packed red blood cell (PRBC) on biochemical values in vitro.

Design:
Prospective observational study.

Setting:
Multidisciplinary intensive care unit (ICU) in a tertiary care centre.

Materials and methods:
We examined samples from 80 PRBC units of different age (the expiration process is defined by national and local hospital standards). The samples originated from the transfusion department where PRBCs were stored in standard conditions. The samples were analysed by a standard-controlled analyser (Critical Care Xpress®, Nova Biomedical) and we recorded the data about the biochemical values in dependence on the PRBC age.

Results:
We found that PRBC age determines a rise of K+ and lactate values and a decrease in pH, Na+ and glycaemia. The measured values were in the range of: potassium 4.0–40.5 mmol/l; lactate 4.1–28.0 mmol/l; pH 7.0–6.65; glycaemia 29.0–14.0 mmol/l; sodium 137–116 mmol/l. Calcium concentration remained stable.

Conclusion:
The administration of large-volume blood transfusion, particularly close to the expiry date of the PRBC unit, can pose a significant risk of possible disturbances in the electrolyte and acid-base balance of the patient.

Keywords:
erythrocyte – PRBC – hyperkalaemia – lactate – metabolic acidosis


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Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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