Evaluation of hematologic, biochemical, and blood gas variables in stored canine packed red blood cells, and the impact of storage time on blood recipients

Abstract

Background: Canine packed red blood cells (pRBCs) can be stored under refrigeration for several days; however, cellular metabolism remains active inside the units, thus producing substances that affect their quality. Objectives: We aimed to evaluate hematologic, biochemical, and blood gas variable alterations that occur in canine pRBCs during storage, and their effects on recipient clinicopathologic parameters. Methods: The study was conducted in two phases. In phase I, 15 pRBC units containing CPDA-1 were stored for 28 days; samples were collected weekly from the units of days 0 to 28 to measure the packed cell volume (PCV), pH, partial pressure carbon dioxide (PCO 2), partial pressure oxygen (PO 2), concentrations of lactate and potassium, and the percent hemolysis. In phase II, another 22 canine pRBC units stored for different time periods (maximum of 21 days) were transfused, and the recipients were evaluated before and after transfusion for changes in clinical parameters (heart rate, respiratory rate, systolic arterial pressure, and rectal temperature) and hematologic variables (PCV, lactate and potassium concentrations, pH, PCO 2 , the ratio of arterial oxygen partial pressure to fractional inspired oxygen [PO 2 /FiO 2 ] ratio, oxygen saturation [SaO 2 ], base excess, and bicarbonate [HCO 3 ]). Results: In the pRBC units, the PCV increased from 70% to 78.33%, the lactate concentration increased 627%, the potassium concentration increased 183%, the percent hemolysis reached 0.69%, and the pH decreased 9% after 28 days. However, the dogs who received transfusions were not negatively affected. There was a significant increase in PCVs, and a significant decrease in heart rates. Conclusion: Canine pRBCs undergo hematologic, blood gas, and biochemical alterations during storage; however, the transfusion of pRBCs stored for up to 21 days increased PCVs without causing harm to the dogs.

Effect of washing units of canine red blood cells on storage lesions

“…Similar to previous studies, our study demonstrated an increase in lactate concentrations and pCO 2 during storage. 14 , 28 , 29 , 30 During storage, erythrocyte metabolic function is more dependent on anaerobic metabolism, which requires the conversion of intra‐cellular pyruvate to lactic acid. 28 , 31 During storage, the erythrocyte intracellular concentration of 2,3‐diphosphoglycerage (2,3‐DPG) decreases, which reduces RBC oxygen carrying capacity and promotes anaerobic metabolism.…”

“… 14 , 28 , 29 , 30 During storage, erythrocyte metabolic function is more dependent on anaerobic metabolism, which requires the conversion of intra‐cellular pyruvate to lactic acid. 28 , 31 During storage, the erythrocyte intracellular concentration of 2,3‐diphosphoglycerage (2,3‐DPG) decreases, which reduces RBC oxygen carrying capacity and promotes anaerobic metabolism. 32 , 33 In both canine and human blood products, lactate begins to increase within 7 days of storage.…”

“… 32 , 33 In both canine and human blood products, lactate begins to increase within 7 days of storage. 14 , 28 The neutralization of this excess lactate results in an excess production of CO 2 . In the presence of carbonic anhydrase and water, the excessive CO 2 will be converted to carbonic acid, 28 contributing to the decrease in the pH of stored units.…”

“… 14 , 28 The neutralization of this excess lactate results in an excess production of CO 2 . In the presence of carbonic anhydrase and water, the excessive CO 2 will be converted to carbonic acid, 28 contributing to the decrease in the pH of stored units. After the first wash, our study demonstrated a significant decrease in both lactate and pCO 2 , but the pH inside the unit continued to decrease, even after 2 additional washes.…”

Sterility Monitoring of Canine Packed Red Blood Cells

“…Before using, blood components usually are visually inspected and bacterial infection should be suspected when there is a discoloration of the component, hemolysis of the upper layers of red blood cells, or presence of visible clots. If such signs are detected, a bacteriological examination of this unit should be provided to determine if contamination occurred (Rodrigues et al, 2020).…”