Mechanical fragility calibration of red blood cells

Mechanical fragility of red blood cells (RBCs) is a critical variable for the hemolysis testing of many important clinical devices, such as pumps, valves, and cannulae, and gas exchange devices. Unfortunately, no standardized test for RBC mechanical fragility is currently well accepted. Although many test devices have been proposed for the study of mechanical fragility of RBCs, no one has ever shown that their results have any relevance to a blood pump. Therefore, the fundamental objective of this study was to determine if one or more test devices could be validated as calibrators to document the fragility of the test blood used for any particular test blood. We compared five mechanical fragility test systems to each other and to a Biopump, with respect to hemolysis. All five devices seem to measure the same parameter; the hemoresistometer most closely matched the pump test results, but the stainless steel bead test may be the most practical for routine calibration purposes.