Podlosky Linda, Poirier Amanda, Nahirniak Susan, Clarke Gwen, Acker Jason P
The Capital Health/Stollery Children's and University of Alberta Hospitals, Edmonton, Alberta, Canada.
Transfusion. 2008 Jul;48(7):1300-7. doi: 10.1111/j.1537-2995.2008.01667.x. Epub 2008 Mar 17.
Pediatric patients may require small-volume transfusions necessitating splitting of red cell (RBC) units. This process usually involves temporary storage of aliquots in pediatric blood bags or, in some cases, plastic syringes, until they are transfused. While many studies have been published on the efficacy of storage in blood bags, there is little evidence to show that RBCs are safe and effective for transfusion after separation into plastic syringe aliquots.
Donor RBC units, stored in either SAG-M (n = 10) or AS-3 additive (n = 11), were split into transfer bags and plastic syringes and stored at either 4 degrees C or room temperature (RT). Half of the aliquots were also irradiated at 25 Gy. RBCs were monitored after 0, 4, and 24 hours of storage with the following variables to assess cellular function and viability: adenosine triphosphate, percent hemolysis, hematocrit, pH, lactate dehydrogenase, extracellular potassium, sodium, and RBC indices.
There was no difference found between irradiated and nonirradiated aliquots or aliquots stored in the refrigerator versus those stored at RT. Significant differences between aliquots stored in approved transfer bags and those stored in syringes were not identified.
Irradiation and storage of aliquoted RBCs demonstrated expected but not significant changes in the in vitro variables. Storage for up to 24 hours in syringes does not have a greater detrimental effect on RBCs than storage in transfer bags, making products stored in either container safe for transfusion to pediatric patients.
儿科患者可能需要小容量输血,这就需要拆分红细胞(RBC)单位。这个过程通常涉及将等分样本临时储存在儿科血袋中,或者在某些情况下,储存在塑料注射器中,直到进行输血。虽然已经发表了许多关于血袋储存效果的研究,但几乎没有证据表明红细胞在分离成塑料注射器等分样本后进行输血是安全有效的。
将储存在SAG-M(n = 10)或AS-3添加剂(n = 11)中的供体红细胞单位拆分到转移袋和塑料注射器中,并分别储存在4℃或室温(RT)下。一半的等分样本也用25 Gy进行辐照。在储存0、4和24小时后监测红细胞的以下变量以评估细胞功能和活力:三磷酸腺苷、溶血百分比、血细胞比容、pH值、乳酸脱氢酶、细胞外钾、钠和红细胞指数。
辐照和未辐照的等分样本之间,以及储存在冰箱中的等分样本与储存在室温下的等分样本之间均未发现差异。未发现储存在批准的转移袋中的等分样本与储存在注射器中的等分样本之间存在显著差异。
对等分的红细胞进行辐照和储存后,体外变量出现了预期但不显著的变化。在注射器中储存长达24小时对红细胞的损害并不比在转移袋中储存更大,这使得储存在任何一种容器中的产品对儿科患者输血都是安全的。