Supported by Canadian Blood Services, Medical Insurance Group of Australia (MIGA) Doctors In Training Grant, SickKids Research Training Institute (RTC) Trainee Start-Up Fund, and University of Toronto Division of Neonatology Trainee Grant Program.
Coinfusion of dextrose-containing fluids and red blood cells does not adversely affect in vitro red blood cell quality
Article first published online: 28 MAR 2014
© 2014 AABB
Volume 54, Issue 8, pages 2068–2076, August 2014
How to Cite
Keir, A. K., Hansen, A. L., Callum, J., Jankov, R. P. and Acker, J. P. (2014), Coinfusion of dextrose-containing fluids and red blood cells does not adversely affect in vitro red blood cell quality. Transfusion, 54: 2068–2076. doi: 10.1111/trf.12618
- Issue published online: 15 AUG 2014
- Article first published online: 28 MAR 2014
- Manuscript Accepted: 15 JAN 2014
- Manuscript Revised: 14 JAN 2014
- Manuscript Received: 21 NOV 2013
- Canadian Blood Services
- Medical Insurance Group of Australia (MIGA) Doctors In Training Grant
- SickKids Research Training Institute (RTC) Trainee Start-Up Fund
- University of Toronto Division of Neonatology Trainee Grant Program
Transfusion guidelines advise against coinfusing red blood cells (RBCs) with solutions other than 0.9% saline. We evaluated the impact of coinfusion with dextrose-containing fluids (DW) on markers of RBC quality.
Study Design and Methods
A pool-and-split design was used to allow conditions to be tested on each pool within 2 hours of irradiation. Three pools at each storage age (5, 14, and 21 days) were created for each phase. In Phase 1, samples were infused through a neonatal transfusion apparatus alone or with treatment solutions: D5W, D10W, D5W/0.2% saline, and 0.9% saline. In Phase 2, samples were incubated alone or in a 1:1 ratio with treatment solutions and tested after 5, 30, and 180 minutes. Hemolysis, supernatant potassium, RBC indices, morphology, and deformability were measured on all samples.
In Phase 1, RBCs transfused alone through the apparatus had higher (p < 0.01) hematocrit, total hemoglobin, and supernatant potassium compared to all other groups. No statistical differences were identified between groups for other measured variables. In Phase 2, mean corpuscular volume of all samples containing DW increased with incubation length and were higher (p < 0.01) than RBCs incubated alone or with 0.9% saline after 30 and 180 minutes. RBCs incubated with D5W and D5W/0.2% saline had greater (p < 0.05) hemolysis than RBCs alone after 180 minutes.
In vitro characteristics of RBCs coinfused with 0.9% saline or D10W were not adversely impacted. When developing clinical studies in neonates, we recommend use of D10W and a transfusion apparatus that minimizes the contact volume of the coinfusate with the RBC.