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Nutricel as an additive solution for neonatal transfusion.
Transfusion Science
|January 6, 2000
Summary
Pediatric red blood cell storage in AS-3 solutions leads to high potassium and citrate levels. This poses risks like hyperkalemia and altered calcium balance during transfusions.
Area of Science:
- Transfusion Medicine
- Pediatric Hematology
- Biochemistry
Background:
- Red blood cell (RBC) concentrates in additive solutions (AS) present challenges for pediatric transfusions.
- Nutricel supernatant removal is common practice in pediatric institutions.
Purpose of the Study:
- To evaluate the biochemical composition of RBCs stored in AS-3 compared to other solutions.
- To assess the implications of these changes for pediatric transfusion safety.
Main Methods:
- Survey of 10 pediatric institutions regarding RBC storage practices.
- Biochemical analysis of packed RBCs stored in AS-3, CP2D, and CPDA1.
- Measurement of potassium, phosphate, citrate, glucose, and pH over time.
Main Results:
- AS-3 stored RBCs showed potassium >15 mmol/l by day 7 and >40 mmol/l by day 35.
- AS-3 had the highest total mass of potassium (5.6 mmol/l) and phosphate.
- AS-3 exhibited increased citrate (1.73 mmoles) and glucose (3.23 mmoles) with pH <6.6 at day 35.
Conclusions:
- High potassium in AS-3 raises concerns for hyperkalemic dysrhythmias during massive transfusions.
- Elevated citrate in AS-3 may impact divalent cation homeostasis.
- Increased glucose in AS-3 could lead to hyperglycemic complications.