The metabolic load of stored blood. Implications for major transfusions in infants.

Abstract

A more detailed knowledge of the substrate load of stored blood would enable potential metabolic disturbances to be accurately predicted when infants receive large blood transfusions. Furthermore, this information is essential for the interpretation of metabolic studies in critically ill infants.Although there is some information on the substrate content of stored blood,7 detailed quantitative data on the substrate load and the effects of storage are not available. This study was designed to measure the electrolyte, metabolite, and hormone content of stored blood in relation to duration of storage. MethodsAliquots of 10 ml were taken from each of 115 units of citrate phosphate dextrose stored blood being used for clinical transfusions. Samples were taken before the six hour expiry time at room temperature. Blood was available for transfusion from the second day after collection after the completion of virological screening for hepatitis antigens. Eighty one samples were taken from blood between two and eight days after collection, and the remainder of the samples were evenly distributed over the subsequent four weeks from collection. Glucose, lactate, pyruvate, alanine, glycerol, and 3-hydroxybutyrate concentrations were measured in perchloric acid extracts of 0*5 ml whole stored blood by the method described by Lloyd and colleagues.8 The remaining sample was centrifuged for five minutes and the separated plasma deep frozen for the subsequent batch analysis of electrolytes (routine laboratory autoanalyser (Astra or Chemispek)), total protein (Biuret method), and the hormones insulin,9 cortisol,10 and growth hormone

Storage Effect on Serum Electrolytes and pH in Whole Blood Stored in Traditional Refrigerator

“…In the former, it was observed that the HCO 3 -values decreased from 19.86 + 0.96mmol/L to 17.38 + 0.60mmol/L. Bicarbonate, pH and chloride levels for both groups were generally observed to decrease with storage time, (figures 1.3, 1.4 and 1.2 respectively).This is in line with the work of [20] who stated that a fall in bicarbonate was observed in stored blood using CPDA-1 anticoagulant preservative [20].Decrease in HCO 3 -may be due to reduction in CO 2 levels due to leakage from the bag. CO 2 produced form metabolism of glucose accumulate and is expected to diffuse through the containing material.…”

“…[18], [9]. The plasma level of potassium may increase by 0.5-1.0mmol/L per day of refrigerator storage [19].There is a notion that the total amount of extracellular potassium in a unit of blood stored for 35days falls within 7mmol/L to 25mmol/L [20]. Chloride is the major anion (negatively charged ion) found in the fluid outside of cells and in the blood.…”

Comparative Study on Some Biochemical Parameters in Stored Whole Blood in Standard Blood Bank and Traditional Refrigerator

“…In the former, it was observed that the HCO 3 -values decreased from 19.86 + 0.96mmol/L to 17.38 + 0.60mmol/L. This is in line with the work of Letham et al who stated that a fall in bicarbonate was observed in stored blood using CPDA-1 anticoagulant preservative [17] . Decrease in HCO 3 -may be due to reduction in CO 2 levels due to leakage from the bag.…”

“…Chloride is the major anion found in the fluid outside of cells and in the blood. In stored whole blood, chloride levels were observed to decrease after two days of storage [17] .…”

“…The plasma level of potassium may increase by 0.5-1.0mmol/L per day of refrigerator storage [16]. There is a notion that the total amount of extracellular potassium in a unit of blood stored for 35days falls within 7mmol/L to 25mmol/L [17] .…”