A comparative study of reducing the extracellular potassium concentration in red blood cells by washing and by reduction of additive solution

Bansal, Ila; Calhoun, Beverly W.; Joseph, Cherilyn; Pothiawala, Mohammad; Baron, Beverly W.

doi:10.1111/j.1537-2995.2007.01095.x

Cited by 32 publications

(32 citation statements)

References 9 publications

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“…[4][5][6][7][8][9][10] The clinical effect(s) of washing on the RBC storage lesion has not been studied.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Some of these changes involve the release into the plasma of biologically active proteins, microvesicles, potassium, acid, and plasticizer, all of which can be reduced by means of standard red cell (RBC) washing procedures. [4][5][6][7][8][9][10] The clinical effect(s) of washing on the RBC storage lesion has not been studied.…”

Section: Introductionmentioning

confidence: 99%

“…Washing has been shown to improve the in vitro characteristics of stored RBCs. [4][5][6][7][8][9][10][14][15][16][17] Earlier generations of cells washers were labor intensive and considered "open systems," which limited the shelf life of washed cells to 24 hours. Current microprocessor-driven, closed-system cell-washers can be programmed to provide extensive cell washing and an approved shelf life of 14 days.…”

Section: Introductionmentioning

confidence: 99%

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Washing older blood units before transfusion reduces plasma iron and improves outcomes in experimental canine pneumonia

Cortés‐Puch

Wang

Sun

et al. 2014

Blood

107

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• Washing older blood before transfusion reduces plasma iron, improving outcomes from established infection in canines.• In contrast, washing fresh blood before transfusion increases in vivo plasma CFH release, worsening outcomes.In a randomized controlled blinded trial, 2-year-old purpose-bred beagles (n 5 24), with Staphylococcus aureus pneumonia, were exchanged-transfused with either 7-or 42-dayold washed or unwashed canine universal donor blood (80 mL/kg in 4 divided doses). Washing red cells (RBC) before transfusion had a significantly different effect on canine survival, multiple organ injury, plasma iron, and cell-free hemoglobin (CFH) levels depending on the age of stored blood (all, P < .05 for interactions). Washing older units of blood improved survival rates, shock score, lung injury, cardiac performance and liver function, and reduced levels of non-transferrin bound iron and plasma labile iron. In contrast, washing fresh blood worsened all these same clinical parameters and increased CFH levels. Our data indicate that transfusion of fresh blood, which results in less hemolysis, CFH, and iron release, is less toxic than transfusion of older blood in critically ill infected subjects. However, washing older blood prevented elevations in plasma circulating iron and improved survival and multiple organ injury in animals with an established pulmonary infection. Our data suggest that fresh blood should not be washed routinely because, in a setting of established infection, washed RBC are prone to release CFH and result in worsened clinical outcomes. (Blood. 2014;123(9):1403-1411 IntroductionTransfusion of older stored canine universal donor blood in a canine model of experimental Staphylococcus aureus pneumonia results in markedly increased lung injury and mortality rates.1 Transfusion with older blood is also associated with increased levels of cell-free hemoglobin (CFH), transferrin bound iron (TBI), non-TBI (NTBI) and plasma labile iron (PLI). NTBI represents iron excess bound to proteins that do not normally handle circulating iron, and PLI is the toxic iron moiety in plasma. Whereas increased nitric oxide scavenging by CFH causing vasoconstriction and vascular injury and increased available iron promoting bacterial growth represent 2 candidate mechanisms of injury, multiple other biological changes have been documented with increasing blood storage interval.2,3 Some of these changes involve the release into the plasma of biologically active proteins, microvesicles, potassium, acid, and plasticizer, all of which can be reduced by means of standard red cell (RBC) washing procedures. [4][5][6][7][8][9][10] The clinical effect(s) of washing on the RBC storage lesion has not been studied.RBC washing has long been performed to reduce potassium levels in stored blood transfused to neonates, debris from RBCs recovered during surgery, cryoprotectant glycerol from cryopreserved RBCs, and plasma proteins from blood intended for patients who have been sensitized to those proteins.11-13 Automated cell washers cap...

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“…[4][5][6][7][8][9][10] The clinical effect(s) of washing on the RBC storage lesion has not been studied.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Washing older blood units before transfusion reduces plasma iron and improves outcomes in experimental canine pneumonia

Cortés‐Puch

Wang

Sun

et al. 2014

Blood

107

View full text Add to dashboard Cite

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“…Potassium load can be minimized in washed RBC transfusions. When transfusion is necessary in hemodialysis patients, washed RBCs are recommended during dialysis-free intervals in order to avoid transfusion-associated hyperkalemia (8)(9)(10). Nevertheless, studies on the effects of washed RBCs on actual change in serum potassium concentration (in the receiver) are limited.…”

Section: Introductionmentioning

confidence: 99%

“…Preservatives, storage temperature, and duration have an effect on the potassium concentration of stored RBCs (7). Washing stored RBCs before transfusion is a recommended method to reduce the potassium load (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Effect of transfusion of washed red blood cells on serumpotassium level in hemodialysis patients

et al. 2017

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Background/aim: This study aimed to compare washed red blood cell (WRBC) transfusion versus nonwashed RBC (NWRBC) transfusion in terms of posttransfusion potassium levels in dialysis patients on a day when the patient did not receive dialysis. Materials and methods:The patients were randomly assigned into two groups, i.e. those receiving WRBCs (n = 21) and those receiving NWRBCs (n = 17). Both groups received one unit of RBCs. Serum potassium and sodium levels were measured before and at the 1st, 2nd, 3rd, 4th, and 6th hours after transfusion.Results: In the WRBC group, the changes in the serum potassium levels at the 3rd, 4th, and 6th hours after transfusion were significant compared with pretransfusion levels. In the serum potassium levels mean decreases by 0.

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Nutrition for the Critically Ill Pediatric Patient with Renal Dysfunction

Rodig

Pediatric Nephrology in the ICU

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A comparative study of reducing the extracellular potassium concentration in red blood cells by washing and by reduction of additive solution

Abstract: Washing pRBCs results in very low levels of K(+). AS reduction also significantly reduces K(+) levels. Selection of the method of K(+) reduction will depend on the stringency of K(+) reduction needed, the time constraints, and the availability of facilities and staff for washing.

Cited by 32 publications

References 9 publications

Washing older blood units before transfusion reduces plasma iron and improves outcomes in experimental canine pneumonia

Washing older blood units before transfusion reduces plasma iron and improves outcomes in experimental canine pneumonia

Effect of transfusion of washed red blood cells on serumpotassium level in hemodialysis patients

Nutrition for the Critically Ill Pediatric Patient with Renal Dysfunction

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