Hemolysis with rapid transfusion systems in the trauma setting

• Published in: Canadian Journal of Surgery Vol. 47; no. 4; pp. 295 - 297
• Main Authors: Kim, Peter, Chin-Yee, Ian, Eckert, Kathleen, Malthaner, Richard A, Gray, Daryl K
• Format: Journal Article
• Language: English
• Published: Canada CMA Impact, Inc 01.08.2004; Canadian Medical Association
• Subjects: Blood Transfusion - methods; Hemolysis; Humans; Time Factors; Transfusion Reaction; Trauma and Critical Care; Wounds and Injuries - therapy
• ISSN: 0008-428X; 1488-2310

Rapid infusion system allows rapid infusion of resuscitation fluids at body temperature in trauma patients. Packed red blood cells are subjected to high external pneumatic pressure (up to 300 mm Hg) and rapid infusion rates through a 170-microm filter. This study was conducted to outline hemolysis that may occur in the setting of massive transfusion (> 10 units). Measurements of various parameters were made before and after infusion of 17 units of outdated (38-82 d) packed red blood cells through a Level 1 Rapid Infuser, including lactate dehydrogenase (LDH), potassium, plasma hemoglobin, hematocrit and total hemoglobin. Hemolysis, expressed as a percentage, was calculated from these parameters. Hemolysis observed in this experiment ranged from near 0 to 0.05%. All the units had plasma potassium concentrations of 15 mmol/L or more. Transfusion of 17 units with the Level 1 Rapid Infuser did not cause a clinically significant amount of hemolysis.