Department of Anaesthesiology, Tokyo Women's Medical University Medical Centre East, Tokyo, Japan.
PLoS One. 2022 May 13;17(5):e0267980. doi: 10.1371/journal.pone.0267980. eCollection 2022.
Acute normovolaemic haemodilution (ANH), as a blood-conservation technique, avoids the need for allogeneic blood transfusions. The historic practice of cold-storing type-O whole blood (WB) in military fields popularised the transfusion of refrigerated WB to treat acute bleeding. In this study, we compared the effects of room temperature (RT) and refrigeration up to 24 hours on the coagulation properties of WB for ANH.
Each WB sample, collected from 12 male volunteers, was divided into two parts, one stored at RT and the other refrigerated for 24 hours. Complete blood counts (CBC), blood gas levels, and coagulation profiles were measured, and rotational thromboelastometry (ROTEM) measurements were performed at the initial collection time point (baseline) and at 6, 12, and 24 hours after initial collection.
The preservation of platelet aggregation response induced by arachidonic acid and adenosine diphosphate was better in cold-stored WB compared to that in RT-stored WB. The platelet aggregation response induced by thrombin receptor-activating peptide 6 was significantly decreased in all samples after 24 hours of storage when compared with that at baseline. The lactate levels in WB stored at RT increased significantly after 6 hours of storage compared to that of cold-stored samples. There were no significant differences in CBC, coagulation parameters, and ROTEM variables between the cold-stored and RT-stored WB samples.
WB for ANH stored in the refrigerator showed better metabolic characteristics after 6 hours of storage and better aggregation response after 12 hours of storage than WB stored at RT.
急性等容血液稀释(ANH)作为一种血液保护技术,可以避免异体输血的需要。在军事领域冷藏 O 型全血(WB)的历史实践推广了冷藏 WB 用于治疗急性出血的输血。在这项研究中,我们比较了室温(RT)和冷藏至 24 小时对用于 ANH 的 WB 凝血特性的影响。
从 12 名男性志愿者采集的每个 WB 样本被分为两部分,一部分储存在 RT,另一部分冷藏 24 小时。在初始采集时间点(基线)和初始采集后 6、12 和 24 小时测量全血细胞计数(CBC)、血气水平和凝血谱,并进行旋转血栓弹性测定(ROTEM)测量。
与 RT 储存的 WB 相比,冷储存的 WB 对花生四烯酸和二磷酸腺苷诱导的血小板聚集反应的保存更好。与基线相比,所有样本在储存 24 小时后,由凝血酶受体激活肽 6 诱导的血小板聚集反应明显降低。与冷储样本相比,在储存 6 小时后,RT 储存的 WB 中的乳酸水平显著增加。与冷储样本相比,RT 储存的 WB 的 CBC、凝血参数和 ROTEM 变量之间没有显著差异。
与 RT 储存的 WB 相比,冷藏储存的 WB 在储存 6 小时后显示出更好的代谢特性,在储存 12 小时后显示出更好的聚集反应。