The effect of viable and nonviable autologous red blood cell transfusions on experimental bacteremia.

Nonviable red blood cells are rapidly cleared from the peripheral blood by the reticuloendothelial system. Since bacteria present in the blood stream are also cleared by the reticuloendothelial system, the possibility that nonviable red blood cells would interfere with the clearance of bacteria has been raised. Groups of dogs were studied in whom an experimental bacteremia was produced by the injection of E. coli (1 x 10(10)/kg). Bacterial clearance, endotoxin clearance, changes in mean arterial pressure, changes in oncotic pressure, and coagulation responses were monitored before and following autologous transfusion of approximately 10 cc/kg of packed red blood cells (PRBC) preserved with acid citrate dextrose or heparinized PRBC stored without preservative. In the latter blood product the majority of the red blood cells were nonviable. Clearance of E. coli over a 4-hr period was similar in the two transfused groups and in a control group without blood transfusion. Mean arterial pressure and blood pH fell significantly in all groups, but was again not significantly different among the groups studied. Endotoxin clearance, changes in oncotic pressure, blood oncotic proteins, and parameters of the blood coagulation system were also similar in all three groups. The results of this study indicate that in normal dogs made acutely bacteremic with E. coli, there were no significant differences over a 4-hr period in their hemodynamic or hematologic responses following transfusion of viable or nonviable autologous red blood cells.