Choi Yoon Ji, Huh Hyub, Bae Go Eun, Ko Eun Ji, Choi Sung-Uk, Park Sang-Hyun, Lim Choon Hak, Shin Hye Won, Lee Hye-Won, Yoon Seung Zhoo
Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam-do Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University Maypure Clinic, Uijeongbu-si, Gyeonggi-do Biomedical Center, Korea University Medical Center, Seoul, Republic of Korea.
Medicine (Baltimore). 2018 Jul;97(28):e11460. doi: 10.1097/MD.0000000000011460.
External applied pneumatic pressure is usually used for rapid transfusion of red blood cells (RBCs). However, increased shear stress can cause increased hemolysis and decreased RBC elongation indices. Therefore, the purpose of this study was to measure the degree of hemolysis and the alteration of RBC elongation indices under varying external pressure in fresh and aged blood.
Venous blood samples were obtained from 20 healthy human volunteers. Each blood bag was divided into 2 subgroups (5 or 35 days of storage), and 5 levels of pressure were applied: 0, 150, 200, 250, and 300 mmHg. After infusion, a laboratory study was conducted. The percentages of irreversibly changed cells were evaluated using Bessis classification. RBC elongation indices were measured using a microfluidic ektacytometer.
There were no significant differences in the percentage of irreversibly changed RBCs between the pressures of 0 and 300 mmHg. Moreover, there were no significant differences in laboratory test results or elongation indices among all levels of pressure. Irreversibly changed RBCs and hemolysis were increased depending on the storage period.
Irreversible changes in RBCs did not occur as a result of external pressure. The hemolysis and elongation indices of fresh RBCs were not influenced by external pneumatic pressure up to 300 mmHg. Only the storage period affected the irreversible changes in RBCs and hemolysis. Therefore, the application of external pressure to RBCs in variously aged blood is likely to be a safe procedure.
外部施加气压通常用于快速输注红细胞（RBC）。然而，剪切应力增加会导致溶血增加和红细胞伸长指数降低。因此，本研究的目的是测量新鲜血液和保存血液在不同外部压力下的溶血程度以及红细胞伸长指数的变化。
从20名健康人类志愿者获取静脉血样本。每个血袋分为2个亚组（保存5天或35天），并施加5个压力水平：0、150、200、250和300mmHg。输注后，进行实验室研究。使用贝西分类法评估不可逆变化细胞的百分比。使用微流控血细胞变形仪测量红细胞伸长指数。
在0至300mmHg压力之间，不可逆变化红细胞的百分比无显著差异。此外，所有压力水平下的实验室检测结果或伸长指数均无显著差异。不可逆变化红细胞和溶血随保存时间增加。
红细胞不可逆变化并非由外部压力导致。新鲜红细胞的溶血和伸长指数在高达300mmHg的外部气压下不受影响。只有保存时间影响红细胞的不可逆变化和溶血。因此，对不同保存时间血液中的红细胞施加外部压力可能是一种安全的操作。
