Hansen T G, Sprogøe-Jakobsen U, Pedersen C M, Olsen K S, Kristensen S R
Department of Anaesthesia and Intensive Care, Odense University Hospital, Odense C, Denmark.
Acta Anaesthesiol Scand. 1998 Jan;42(1):57-62. doi: 10.1111/j.1399-6576.1998.tb05081.x.
The vast majority of infusion pumps used for rapid transfusion of large amounts of blood have never been properly examined regarding their influence on the quality of the red blood cells (RBCs) infused. In this study, we evaluated the effect of two different infusion pumps on the degree of RBC destruction following rapid experimental blood transfusion.
Divided into 2 groups according to age, 30 u of SAGM RBCs were infused through an experimental transfusion model by either a manual roller pump (MRP) or a pressure infusor pump (PIP). Fresh (i.e stored for 8-11 d) RBCs, 20 u, and 10 u of older (i.e. stored for 25-33 d) RBCs were randomly allocated to infusion with either of the two pumps. The rate of infusion was as fast as possible with the MRP, and with the PIP adjusted with an external applied pressure of 300 mm Hg. RBC samples collected before and after infusion were analyzed for total haemoglobin, free haemoglobin, haematocrit, total free potassium, lactate dehydrogenase (LDH) and the percentage of haemolysis. The time spent for each transfusion was measured by a stop watch.
Following infusion, a marginal increase (i.e. considerably below 0.8%) in the percentage of haemolysis and LDH content was seen with both pumps. This increase was only statistically significant when RBCs stored for 8-11 d were used (P = 0.002 for both parameters). Irrespective of the age of the RBCs, no differences between the two pumps could be detected. Compared to the PIP, infusion with the MRP could be accomplished significantly faster, i.e. median 5.9 ml/s (5.2-6.4 ml/s) versus 2.9 ml/s (2.5-3.2 ml/s), (P < 0.0001).
Both the pumps used in this study are safe alternatives for rapid transfusion of RBCs; however, with MRP this can be accomplished approximately twice as fast as with the PIP.
绝大多数用于快速大量输血的输液泵从未就其对所输注红细胞（RBC）质量的影响进行过恰当检测。在本研究中，我们评估了两种不同输液泵对快速实验性输血后红细胞破坏程度的影响。
根据年龄分为2组，通过实验性输血模型，用手动滚压泵（MRP）或压力输注泵（PIP）输注30单位的SAGM红细胞。将新鲜（即储存8 - 11天）的20单位红细胞和储存时间较长（即储存25 - 33天）的10单位红细胞随机分配给两种泵中的一种进行输注。MRP以尽可能快的速度输注，PIP通过施加300 mmHg的外部压力进行调节。对输注前后采集的红细胞样本进行总血红蛋白、游离血红蛋白、血细胞比容、总游离钾、乳酸脱氢酶（LDH）和溶血百分比分析。每次输血所用时间用秒表测量。
输注后，两种泵的溶血百分比和LDH含量均有轻微增加（即显著低于0.8%）。仅在使用储存8 - 11天的红细胞时，这种增加具有统计学意义（两个参数的P值均为0.002）。无论红细胞的储存时间如何，两种泵之间均未检测到差异。与PIP相比，使用MRP输注可显著更快完成，即中位数为5.9 ml/s（5.2 - 6.4 ml/s），而PIP为2.9 ml/s（2.5 - 3.2 ml/s），（P < 0.0001）。
本研究中使用的两种泵都是快速输注红细胞的安全选择；然而，使用MRP完成输注的速度约为PIP的两倍。
