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Compatibility of packed erythrocytes and Ringer's lactate solution
D L Cull1, K P Lally, K D Murphy
1Department of Surgery, Wilford Hall USAF Medical Center, Lackland, Texas 78236-5300.
Surgery, Gynecology & Obstetrics
|July 1, 1991
Summary
Ringer's lactate can be safely used to dilute packed red blood cells during rapid transfusions. This study found no clot formation in clinically relevant dilutions, ensuring transfusion safety.
Area of Science:
- Transfusion Medicine
- Emergency Medicine
- Biocompatibility Studies
Background:
- Packed erythrocytes are often diluted with crystalloid solutions for rapid infusion.
- Concerns exist regarding the use of calcium-containing solutions like Ringer's lactate with citrate-anticoagulated blood due to potential clot formation.
- Citrate phosphate dextrose (CPD) is a common anticoagulant used for preserving packed erythrocytes.
Purpose of the Study:
- To evaluate the safety and compatibility of Ringer's lactate solution as a diluent for CPD-preserved packed erythrocytes.
- To assess the risk of clot formation when mixing Ringer's lactate with packed erythrocytes in various ratios.
- To compare the flow rates of packed erythrocytes diluted with Ringer's lactate versus normal saline.
Main Methods:
- CPD-preserved packed erythrocytes were diluted with Ringer's lactate or normal saline at ratios from 5:1 to 1:20.
- Samples were incubated at room temperature and 37°C, with clot formation monitored up to two hours.
- Packed erythrocytes were diluted to specific hematocrit values (35-65%) and passed through a 170-micron filter to compare flow rates.
Main Results:
- No clot formation was observed in clinically relevant dilutions of packed erythrocytes to Ringer's lactate (ratios 5:1 to 2:1).
- Clotting occurred at dilutions of 1:1 and beyond.
- No significant difference in flow rates was found between packed erythrocytes diluted with Ringer's lactate and normal saline.
Conclusions:
- Ringer's lactate solution is compatible with CPD-preserved packed erythrocytes and can be safely used as a diluent in emergency settings.
- The study supports the use of Ringer's lactate for rapid blood transfusions without compromising erythrocyte integrity or flow.
- Clinical dilutions pose no significant risk of clot formation, validating its use in transfusion protocols.
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