Hemolysis with rapid transfusion systems in the trauma setting
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 t...
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| Published in | Canadian Journal of Surgery Vol. 47; no. 4; pp. 295 - 297 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Canada
CMA Impact, Inc
01.08.2004
Canadian Medical Association |
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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Measurements of various parameters were made before and after infusion of 17 units of outdated (38-82 d) packed red blood cells through a Level 1 Rapid Infuser, including lactate dehydrogenase (LDH), potassium, plasma hemoglobin, hematocrit and total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. |
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| AbstractList | 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 Measurements of various parameters were made before and after infusion of 17 units of outdated (38-82 d) packed red blood cells through a Level 1 Rapid Infuser, including lactate dehydrogenase (LDH), potassium, plasma hemoglobin, hematocrit and total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. 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. OBJECTIVERapid 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).METHODS AND MATERIALSMeasurements 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.RESULTSHemolysis observed in this experiment ranged from near 0 to 0.05%. All the units had plasma potassium concentrations of 15 mmol/L or more.CONCLUSIONTransfusion of 17 units with the Level 1 Rapid Infuser did not cause a clinically significant amount of hemolysis. |
| Author | Chin-Yee, Ian Gray, Daryl K Kim, Peter Eckert, Kathleen Malthaner, Richard A |
| AuthorAffiliation | From the Faculty of Medicine, University of Western Ontario, the †Department of Medicine, Division of Hematology and Oncology, London Health Sciences Centre, the ‡London Laboratory Health Sciences Group, London Health Sciences Centre and St. Joseph's Health Centre, the §Department of Surgery, Division of Thoracic Surgery, London Health Sciences Centre and the ¶Department of Surgery, London Health Sciences Centre, London, Ont |
| AuthorAffiliation_xml | – name: From the Faculty of Medicine, University of Western Ontario, the †Department of Medicine, Division of Hematology and Oncology, London Health Sciences Centre, the ‡London Laboratory Health Sciences Group, London Health Sciences Centre and St. Joseph's Health Centre, the §Department of Surgery, Division of Thoracic Surgery, London Health Sciences Centre and the ¶Department of Surgery, London Health Sciences Centre, London, Ont |
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| References | 2000884 - Am J Hosp Pharm. 1991 Jan;48(1):92-7 3705900 - Acta Anaesthesiol Scand. 1986 Feb;30(2):139-44 10670874 - Am J Surg. 1999 Dec;178(6):570-2 11399823 - Transfusion. 2001 Jun;41(6):799-802 8146907 - Transfusion. 1994 Mar;34(3):278-9 11100422 - Int Anesthesiol Clin. 2000 Fall;38(4):141-8 1650023 - Resuscitation. 1991 Apr;21(2-3):207-27 6464156 - Transfusion. 1984 Jul-Aug;24(4):323-6 2240660 - Anesthesiology. 1990 Nov;73(5):1050-2 10897264 - Surg Clin North Am. 2000 Jun;80(3):845-54 |
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| SubjectTerms | Blood Transfusion - methods Hemolysis Humans Time Factors Transfusion Reaction Trauma and Critical Care Wounds and Injuries - therapy |
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| Title | Hemolysis with rapid transfusion systems in the trauma setting |
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