Red Blood Cell Metabolism during Storage: Basic Principles and Practical Aspects

Hess, John R.; Beyer, Ginine M.

doi:10.1016/b978-0-443-06981-9.50018-1

Cited by 18 publications

(23 citation statements)

References 62 publications

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“…Although elevated extracellular K + concentrations in stored RBC units are not usually of clinical significance, they can, however, be fatal if RBCs are infused in large volumes through central vascular catheters, as in neonatal exchange transfusions or when priming cardiopulmonary bypass machines. 13 One of the major concerns of neonatologists when transfusing stored RBC units is the increase of K + . 14 Although this concern is quite legitimate for largevolume (Ն25 mL/Kg) transfusions, we agree with other authors that it likely does not apply in the small-volume setting.…”

Section: Discussionmentioning

confidence: 99%

Efficacy in reducing potassium load in irradiated red cell bags with a potassium adsorption filter

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Efficacy in reducing potassium load in irradiated red cell bags with a potassium adsorption filter

et al. 2008

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“…While the FDA has approved storage of pRBCs for 42 days in various storage solutions, the storage of whole blood is limited to 21 days in CPD, CP2D and 35 days in CPDA-1 (64). The FDA established shelf-life is based on a minimum of 75% RBC survival in recipient circulation 24 h after transfusion (48,(65)(66)(67). Previous studies have examined some aspects of red blood cell viability in whole blood beyond the standard storage period (68,69).…”

Section: Discussionmentioning

confidence: 99%

Expired But Not Yet Dead: Examining the Red Blood Cell Storage Lesion in Extended-Storage Whole Blood

Pulliam

Joseph²,

Veile³

et al. 2020

Shock

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Whole blood is a powerful resuscitation strategy for trauma patients but has a shorter shelf life than other blood products. The red blood cell storage lesion in whole blood has not previously been investigated beyond the standard storage period. In the present study, we hypothesized that erythrocytes in stored whole blood exhibit similar aspects of the red blood cell storage lesion and that transfusion of extended storage whole blood would not result in a more severe inflammatory response after hemorrhage in a murine model. To test this hypothesis, we stored low-titer, O-positive, whole blood units, and packed red blood cells (pRBCs) for up to 42 days, then determined aspects of the red blood cell storage lesion. Compared with standard storage pRBCs, whole blood demonstrated decreased microvesicle and free hemoglobin at 21 days of storage and no differences in osmotic fragility. At 42 days of storage, rotational thromboelastometry demonstrated that clotting time was decreased, alpha angle was increased, and clot formation time and maximum clot firmness similar in whole blood as compared with pRBCs with the addition of fresh frozen plasma. In a murine model, extended storage whole blood demonstrated decreased microvesicle formation, phosphatidylserine, and cell-free hemoglobin. After hemorrhage and resuscitation, TNF-a, IL-6, and IL-10 were decreased in mice resuscitated with whole blood. Red blood cell survival was similar at 24 h after transfusion. Taken together, these data suggest that red blood cells within whole blood stored for an extended period of time demonstrate similar or reduced accumulation of the red blood cell storage lesion as compared with pRBCs. Further examination of extended-storage whole blood is warranted.

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“…Additionally, we confirmed that mannitol, which can also induce changes in the osmotic pressure, led to the formation of a biconcave shape in RBCs. A number of additive solutions have been developed to extend the storage period of RBCs up to 6 weeks [43], after separation of blood into RBCs and plasma in clinical settings. Importantly, most of these additive solutions contain mannitol for the prevention of hemolysis and protection of the cell membrane [40].…”

Section: Plos Onementioning

confidence: 99%

Effects of osmolality and solutes on the morphology of red blood cells according to three-dimensional refractive index tomography

Son

Lee

et al. 2021

PLoS ONE

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Phosphate-buffered saline (PBS) and Alsever’s solution (AS) are frequently used as media in blood-related studies, while 0.9% normal saline (NS) is frequently used in transfusion medicine. Despite the frequent use, the effects of these solutions on the shape and volume of red blood cells (RBCs) have not been reported. We collected blood samples from five healthy adults and used three-dimensional refractive index tomography to investigate the changes in the morphology of RBCs caused by changes in osmolality and solutes at the single-cell level. After diluting 2 μL of RBCs 200-fold with each solution (PBS, AS, and 0.9% NS), 40 randomly selected RBCs were microscopically observed. RBC shape was measured considering sphericity, which is a dimensionless quantity ranging from 0 (flat) to 1 (spherical). RBCs in plasma or AS showed a biconcave shape with a small sphericity, whereas those in 0.9% NS or PBS showed a spherical shape with a large sphericity. Moreover, we confirmed that sodium chloride alone could not elicit the biconcave shape of RBCs, which could be maintained only in the presence of an osmotic pressure-maintaining substance, such as glucose or mannitol. Although 0.9% NS solution is one of the most commonly used fluids in hematology and transfusion medicine, RBCs in 0.9% NS or PBS are not biconcave. Therefore, as the debate on the use of NS continues, future clinical studies or applications should consider the effect of glucose or mannitol on the shape of RBCs.

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Red Blood Cell Metabolism during Storage: Basic Principles and Practical Aspects

Cited by 18 publications

References 62 publications

Efficacy in reducing potassium load in irradiated red cell bags with a potassium adsorption filter

Efficacy in reducing potassium load in irradiated red cell bags with a potassium adsorption filter

Expired But Not Yet Dead: Examining the Red Blood Cell Storage Lesion in Extended-Storage Whole Blood

Effects of osmolality and solutes on the morphology of red blood cells according to three-dimensional refractive index tomography

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