“…In both human and veterinary medicine, storage of blood products can increase erythrocyte fragility, causing an increase in in vitro hemolysis and free Hgb concentrations. 15 , 29 , 36 , 37 , 38 An increase in red cell fragility and hemolysis can result in the release of cell‐free Hgb, which can contribute to multiple organ failure, 39 lung injury, 40 , 41 , 42 , 43 , 44 bacterial infections, 19 systemic and pulmonary hypertension, 40 kidney injury, and endothelial dysfunction. 21 Hemoglobin effectively scavenges nitric oxide, causing endothelial dysfunction, vasoconstriction, platelet aggregation, increased vascular permeability, and leukocyte adhesion.…”