Observations on the biochemical effects of transfusion of citrate-phosphate-dextrose stored blood in man
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Transfusing citrate phosphate dextrose (CPD) blood can decrease ionized calcium levels and increase parathyroid hormone. Arterial blood monitoring is crucial for accurate assessment of these biochemical changes during transfusion.
Area of Science:
- Biochemistry
- Physiology
- Transfusion Medicine
Background:
- Blood transfusions are common medical procedures.
- Citrate phosphate dextrose (CPD) is a widely used anticoagulant preservative for stored blood.
- Understanding the biochemical effects of CPD blood transfusion is essential for patient safety.
Purpose of the Study:
- To investigate the immediate biochemical effects of transfusing three units of CPD blood in humans.
- To monitor changes in ionized calcium, parathyroid hormone, blood pressure, and plasma potassium levels during CPD blood transfusion.
Main Methods:
- Transfusion of three units of CPD stored blood at a rate of 50 ml/min.
- Monitoring of arterial blood specimens for ionized calcium and parathyroid hormone levels.
- Measurement of blood pressure and plasma potassium levels.
Main Results:
- A decrease in free (ionized) calcium levels was observed approximately two minutes after initiating transfusion.
- Peripheral parathyroid hormone levels increased two to four minutes post-transfusion initiation.
- Transient decreases in blood pressure occurred during transfusion, with recovery upon cessation and no further drops upon restarting.
Conclusions:
- CPD blood transfusion can induce significant acute biochemical alterations, including hypocalcemia and hormonal changes.
- Arterial blood sampling is necessary for accurate monitoring of ionized calcium levels due to rapid dilution and mixing effects.
- Further research is warranted to fully elucidate the clinical implications of these findings and optimize transfusion protocols.
Abstract:
Preliminary data on the biochemical effects of the transfusion of three units of CPD blood in man is presented. Free (ionized) calcium was found to decrease approximately two minutes following initiation of the transfusion of CPD stored blood at a rate of 50 ml/min. Due to mixing problems, arterial and not venous specimens were found necessary to monitor accurately the severity of these decreases. Parathyroid hormone in the peripheral blood was found to increase two to four minutes after the initiation of transfusion. Decreases in blood pressure were observed during transfusion. The blood pressure recovered when the transfusion was stopped and did not decrease any further after restarting the transfusion, were found out not to increase or decrease consistently, and only modest changes in plasma potassium were observed.