Effects of oxygen and mixing on red cells stored in plastic bags at +4 degrees C

When red cells are stored in plastic (PVC) containers the penetration of blood gases--O2 entering into and CO2 escaping out of the blood units--influences the red cell metabolism; ATP and energy charge are better maintained at anaerobic storage. When sedimented cells are stored unmixed, the blood gas diffusion is markedly restricted and the concentration of metabolites is rapidly increasing. This leads to disturbed metabolism, increased microvesiculation and decreased erythrocyte fluidity. In a blood transfusion service producing blood components, this is likely to have an important impact on the quality of the red cells. It seems advisable to store red cells in a sufficiently large volume of a suspension medium (such as the SAGM solution) and apply mixing during storage.