Fujita Hiroshi, Teratani Miyuki, Hazama Yuki, Nakahara Michiyo, Asaka Hiroyuki, Nishimura Shigeko
Department of Transfusion Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Clinical Laboratory, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Transfusion. 2018 Oct;58(10):2383-2387. doi: 10.1111/trf.14897. Epub 2018 Sep 4.
Ammonia in the plasma usually does not pass through the blood-brain barrier (BBB). However, it can affect the brain as a neurotoxin in neonates with anemia of prematurity. Excess intake of ammonia should therefore be restricted in conditions involving BBB breakdown, such as in premature neonates. A potassium adsorption filter (PAF) can remove not only potassium, but also ammonia from red blood cell (RBC) solution. PAF for neonates (PAF-n) has been recently introduced using small satellite packs. We evaluated the effects of PAF-n on the removal of ammonia and potassium from RBC solution in small satellite packs.
RBC solutions were obtained from the Japanese Red Cross Society. Two units of RBC solution (280 mL) were divided into four satellite packs (70 mL/pack). The RBC solution was passed through PAF-n (Kawasumi Laboratories Inc.) that was primed with saline (100 mL) before use. The concentrations of ammonia and potassium were measured in the solution before and after filtration (four samples of 10 mL each of filtered RBC solution) by Biomedical Laboratories.
Approximately 47 to 82 and 84% to 93% of ammonia and potassium were removed from the RBC solution, respectively, without dilution with saline.
PAF-n can remove ammonia and potassium from RBC solution in small satellite packs. PAF-n could therefore improve the clinical prognosis of neonates with poorly developed BBB by limiting the delivery of excess ammonia found in the RBC solution.
血浆中的氨通常不会透过血脑屏障（BBB）。然而，在患有早产儿贫血的新生儿中，它可作为神经毒素影响大脑。因此，在涉及血脑屏障破坏的情况下，如早产儿，应限制氨的过量摄入。钾吸附滤器（PAF）不仅可以去除钾，还可以从红细胞（RBC）溶液中去除氨。最近已推出使用小型卫星包装的新生儿用PAF（PAF-n）。我们评估了PAF-n对从小型卫星包装的RBC溶液中去除氨和钾的效果。
红细胞溶液取自日本红十字会。将两单位红细胞溶液（280 mL）分成四个卫星包装（70 mL/包）。红细胞溶液通过使用前用生理盐水（100 mL）预充的PAF-n（川澄制药株式会社）。通过生物医学实验室测量过滤前后溶液中氨和钾的浓度（过滤后的红细胞溶液各10 mL的四个样品）。
在不使用生理盐水稀释的情况下，分别从红细胞溶液中去除了约47%至82%的氨和84%至93%的钾。
PAF-n可以从小型卫星包装的红细胞溶液中去除氨和钾。因此，PAF-n可以通过限制红细胞溶液中过量氨的输送来改善血脑屏障发育不良的新生儿的临床预后。
