Centre for Innovation, Canadian Blood Services, 4450-2350 Health Sciences Mall, Vancouver, British ColumbiaV6T 1Z3, Canada.
Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada.
Transfusion. 2022 Apr;62(4):797-808. doi: 10.1111/trf.16833. Epub 2022 Feb 25.
Mechanical stress on red blood cells is associated with using infusion pumps for blood administration. Current standards in North America leave it to healthcare facilities to consult with manufacturers about infusion pump safety for transfusion; studies on various pumps and red blood cell (RBC) conditions are scarce.
RBC units were pumped through four infusion pumps on d22 (22 days postcollection), d40, d28 after gamma irradiation on d14 (I14d28), and d22 after irradiation on d21 (I21d22). For each experiment, three units were pooled and split among four bags. Samples were collected at gravity and after pumping at clinical nonemergency rates. Hemolysis %, microvesicles, potassium, lactate dehydrogenase, mechanical fragility index levels, and morphology evaluations were performed (n = 5-6).
Hemolysis levels of Piston and Linear Peristaltic pump samples were not different from hemolysis of corresponding gravity samples. Peristaltic samples had significantly higher hemolysis compared to gravity, and other pumps, however, maximum mean difference was limited to 0.05%. Pumping at 50 mL/h resulted in the highest hemolysis level. Change in hemolysis % due to pumping was significantly higher in d40 and I21d22 units. No combination of pumps and RBCs conditions led to hemolysis >0.8%. Besides hemolysis, lactate dehydrogenase release was the only marker that demonstrated some differences between infusions via pump versus gravity.
The pump design affects the degree of hemolysis. However, for all tested pumps and RBC conditions, this increase was minimal. Hemolysis measurement on d40 and I21d22 at 50 mL/h were concluded to be appropriate parameters for pump evaluation.
红细胞受到机械压力与使用输液泵进行血液给药有关。目前，北美的标准是让医疗机构与制造商协商输液泵的输血安全性；关于各种输液泵和红细胞（RBC）条件的研究很少。
在 d22（采集后第 22 天）、d40、d14 经γ射线照射后的 d28（I14d28）和 d21 经照射后的 d22（I21d22），通过四个输液泵泵入 RBC 单位。对于每个实验，将三个单位汇集并分为四个袋子。在重力和临床非紧急速率下进行泵送后采集样本。进行溶血%、微泡、钾、乳酸脱氢酶、机械脆性指数水平和形态评估（n=5-6）。
活塞和线性蠕动泵样本的溶血水平与重力样本的溶血水平没有差异。蠕动泵样本的溶血水平明显高于重力样本，但其他泵的最大平均差异限于 0.05%。以 50mL/h 的速度泵送会导致溶血水平最高。在 d40 和 I21d22 单位中，由于泵送导致的溶血百分比变化显著更高。除溶血外，乳酸脱氢酶释放是唯一表明通过泵与重力输注之间存在一些差异的标志物。
泵的设计会影响溶血的程度。然而，对于所有测试的泵和 RBC 条件，这种增加是最小的。在 50mL/h 时，对 d40 和 I21d22 进行溶血测量被认为是评估泵的适当参数。
