Air Embolism in Blood Donors

Ende, Norman; Ziskind, Joseph

doi:10.1001/jama.1950.82910520002008a

Cited by 4 publications

(5 citation statements)

References 4 publications

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“…The phrase “primum non nocere,” Latin for “above all, do no harm,” has been a golden rule in medicine since it was founded by English physician Thomas Sydenham in the 1860s 18 . Hence, determining the risk of iatrogenic harm to the donor was an important outcome in this study, considering that air embolisms in both donor and patient was a known complication before the time of plastic infusion bags 19,20 . On the background of this risk, the BC 2 L was designed with a venting port connected to a three‐way stop cock, allowing for potential overpressure to escape the bottle before the needle is introduced to the donor.…”

Section: Discussionmentioning

confidence: 94%

“…18 Hence, determining the risk of iatrogenic harm to the donor was an important outcome in this study, considering that air embolisms in both donor and patient was a known complication before the time of plastic infusion bags. 19,20 On the background of this risk, the BC 2 L was designed with a venting port connected to a three-way stop cock, allowing for potential overpressure to escape the bottle before the needle is introduced to the donor. Throughout this trial we did not encounter any occurrences of backflow or any other safety concerns for the donor.…”

Section: What Are the Risks Of Causing Iatrogenic Harm To The Donor?mentioning

confidence: 99%

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Drawing and storing blood using a 3D printed bottle cap and a disinfected 500 mL drinking bottle: A proof‐of‐concept study

Rognhaug,

Eliassen

2024

Transfusion

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BackgroundToday, with wars raging in Ukraine and the Middle East, the demand for blood is high. Despite this, few companies produce the necessary equipment to draw, store, and transfuse whole blood. This study evaluated the safety and performance of a 3D printed bottle cap in conjunction with a water bottle and some available consumables to draw and store fresh whole blood.Study Design and MethodsBags of saline, and freshly donated whole blood, was transferred to the water bottle through a 3D printed bottle cap and stored for 72 h. An identical setup, transferring saline to a Terumo blood collection bag was used as control. Performance and safety were evaluated by calculating infusion rate and observing for backflow, respectively. The blood was also tested for hemolysis and bacterial growth at four sampling points.ResultsThe cap‐and‐bottle setup was faster than control in terms of flow rate when transferring saline (1.53 vs. 1.81 mL/s, p < .001), and non‐inferior to saline control when transfusing blood (1.53 vs. 1.49 mL/s, p = .641). We did not observe any risks of causing the donor iatrogenic harm, and there was no evidence of increased hemolysis. However, there were traces of bacterial contamination in three of six bottles.ConclusionThis study indicates that drawing blood is both feasible and safe, utilizing a 3D printed cap and bottle setup. Flow rate was faster than control, and mechanical properties of the blood were not affected. We were unable to determine the source of bacterial contamination in the blood.

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Section: Discussionmentioning

confidence: 94%

Section: What Are the Risks Of Causing Iatrogenic Harm To The Donor?mentioning

confidence: 99%

Drawing and storing blood using a 3D printed bottle cap and a disinfected 500 mL drinking bottle: A proof‐of‐concept study

Rognhaug,

Eliassen

2024

Transfusion

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“…For air embolism to result in a fatality, large volumes (200 mL plus) of air are required [45]. Fatalities associated with the use of older apheresis technology occurred in the 1940s/1950s due to positive pressure in the circuit, resulting in air being sucked into the circulation [46]. Modern apheresis machines make significant air embolism unlikely given standard alarms and inbuilt controls.…”

Section: Air Embolismmentioning

confidence: 99%

A donor safety evidence literature review of the short‐ and long‐term effects of plasmapheresis

Hoad,

Castrén,

Norda

et al. 2023

Vox Sanguinis

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Many blood establishments are expanding plasmapheresis collection capacity to achieve increasing plasma for fractionation volume targets, driven by immunoglobulin product demand. Some adverse events occur in both apheresis and whole blood collection, such as venepuncture‐related trauma and vasovagal reactions. Others are specifically related to the apheresis procedure, such as citrate reactions, haemolysis, infiltration and air embolism. Whilst plasmapheresis procedures are generally well tolerated, theoretical longer term donor health considerations, such as the effects on donor plasma protein levels, bone mineral density, iron deficiency and malignancy also require consideration. An evidence‐based framework that supports a safe and sustainable increase in the collection of plasma is essential. Our review demonstrates a lack of high‐quality evidence on risks and outcomes specifically in plasmapheresis. Whilst conservative procedural controls and donor harm minimization policies will mitigate risk, high‐quality evidence is needed to facilitate practice change that is safe and sustainable and maximizes the potential of individual donor differences.

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“…An evacuated bottle was used for the draw. 52 Donating blood using an evacuated container carried a serious risk of death or impairment. As instructed, the patient began to open and close his fist to enhance flow, but this was unsuccessful.…”

Section: Phlebotomymentioning

confidence: 99%

“…52 Reverse flow (ie, air from bottle retrogrades into the needle) can be achieved even with the tourniquet in place, but the risk becomes explosive if the tourniquet is released while the needle remains open and in the patient's arm. As blood enters a non-vacuum-sealed bottle, air pressure builds up.…”

Section: Phlebotomymentioning

confidence: 99%

Infusion-Related Air Embolism

Cook¹

2013

Journal of Infusion Nursing

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Vascular air embolism as a medically induced complication may be associated with numerous treatments and therapies. In infusion therapy, the risk is associated with venous and arterial catheterization as well as various other invasive procedures and much of the equipment used for them. The manner of air entry and the presentation of symptoms may vary greatly. Appropriate treatment options are dependent on air entry routes. Nurses need to be aware of the common and seldom-considered causes of air embolism to be able to guard against this complication, yet adequately support the patient if it occurs.

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Air Embolism in Blood Donors

Cited by 4 publications

References 4 publications

Drawing and storing blood using a 3D printed bottle cap and a disinfected 500 mL drinking bottle: A proof‐of‐concept study

Drawing and storing blood using a 3D printed bottle cap and a disinfected 500 mL drinking bottle: A proof‐of‐concept study

A donor safety evidence literature review of the short‐ and long‐term effects of plasmapheresis

Infusion-Related Air Embolism

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