Strauss R G, Bell E F, Snyder E L, Elbert C, Crawford G, Floss A, Wilmoth P K, Rios G R, Koontz F P
J Pediatr. 1986 Jul;109(1):109-13. doi: 10.1016/s0022-3476(86)80587-x.
We examined the quality of blood components dispensed in syringes for transfusion into neonates, including the effects on quality of environmental conditions to which blood is exposed when it is transfused into neonates nursed in warm-air incubators or under radiant warmers. Syringes of blood placed in incubators rapidly warmed to 36 degrees C. Blood placed under radiant warmers operated at full power was heated rapidly to temperatures approaching 45 degrees C, and all blood components exhibited evidence of falling pH and cellular damage after 6 hours exposure to radiant energy. Erythrocyte damage was suggested by an increase in plasma hemoglobin, potassium, and lactic dehydrogenase. Platelets lost the ability to recover from hypotonic shock. Granulocytes exhibited a marked defect in the ability to produce superoxide anion after stimulation. The excessive warming and functional abnormalities exhibited by all blood components exposed to infrared energy were abrogated when syringes were shielded by covering them with aluminum foil. The clinical importance of these experimental findings remains to be established. Meanwhile, it would seem prudent either to shield syringes of blood placed under radiant warmers by covering them with aluminum foil or to limit the volume of a single transfusion to a quantity that can be infused within a relatively brief period.
我们检查了用于新生儿输血的注射器中所分发血液成分的质量，包括当血液输给在暖箱中或辐射保暖器下护理的新生儿时，暴露于环境条件下对血液质量的影响。置于暖箱中的血样注射器迅速升温至36摄氏度。置于全功率运行的辐射保暖器下的血液迅速升温至接近45摄氏度，且所有血液成分在暴露于辐射能量6小时后均出现pH值下降和细胞损伤的迹象。血浆血红蛋白、钾和乳酸脱氢酶升高提示红细胞受损。血小板失去了从低渗休克中恢复的能力。粒细胞在受到刺激后产生超氧阴离子的能力出现明显缺陷。当用铝箔覆盖注射器对其进行屏蔽时，所有暴露于红外能量的血液成分所表现出的过度升温及功能异常均被消除。这些实验结果的临床重要性仍有待确定。同时，要么用铝箔覆盖置于辐射保暖器下的血样注射器进行屏蔽，要么将单次输血量限制在相对较短时间内可输注的量，这样做似乎较为谨慎。
