title: Haemolysis following rapid experimental red blood cell transfusion--an evaluation of two infusion pumps.
abstract: BACKGROUND
  The vast majority of infusion pumps used for rapid transfusion of large amounts of blood have never been properly examined regarding their influence on the quality of the red blood cells (RBCs) infused. In this study, we evaluated the effect of two different infusion pumps on the degree of RBC destruction following rapid experimental blood transfusion.
  
  
  METHODS
  Divided into 2 groups according to age, 30 u of SAGM RBCs were infused through an experimental transfusion model by either a manual roller pump (MRP) or a pressure infusor pump (PIP). Fresh (i.e stored for 8-11 d) RBCs, 20 u, and 10 u of older (i.e. stored for 25-33 d) RBCs were randomly allocated to infusion with either of the two pumps. The rate of infusion was as fast as possible with the MRP, and with the PIP adjusted with an external applied pressure of 300 mm Hg. RBC samples collected before and after infusion were analyzed for total haemoglobin, free haemoglobin, haematocrit, total free potassium, lactate dehydrogenase (LDH) and the percentage of haemolysis. The time spent for each transfusion was measured by a stop watch.
  
  
  RESULTS
  Following infusion, a marginal increase (i.e. considerably below 0.8%) in the percentage of haemolysis and LDH content was seen with both pumps. This increase was only statistically significant when RBCs stored for 8-11 d were used (P = 0.002 for both parameters). Irrespective of the age of the RBCs, no differences between the two pumps could be detected. Compared to the PIP, infusion with the MRP could be accomplished significantly faster, i.e. median 5.9 ml/s (5.2-6.4 ml/s) versus 2.9 ml/s (2.5-3.2 ml/s), (P < 0.0001).
  
  
  CONCLUSIONS
  Both the pumps used in this study are safe alternatives for rapid transfusion of RBCs; however, with MRP this can be accomplished approximately twice as fast as with the PIP.
authors.affiliation: Department of Anaesthesia and Intensive Care, Odense University Hospital, Odense C, Denmark.
authors.forename: T G
authors.initials: TG
authors.lastname: Hansen
authors.forename: U
authors.initials: U
authors.lastname: Sprogøe-Jakobsen
authors.forename: C M
authors.initials: CM
authors.lastname: Pedersen
authors.forename: K S
authors.initials: KS
authors.lastname: Olsen
authors.forename: S R
authors.initials: SR
authors.lastname: Kristensen
mesh_terms: D000225:Adenine; D001793:Blood Preservation; D004905:Erythrocyte Aging; D017707:Erythrocyte Transfusion / Q000295:instrumentation / Q000379:methods*; D005069:Evaluation Studies as Topic; D005947:Glucose; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D007260:Infusion Pumps; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008353:Mannitol; D011188:Potassium / Q000097:blood; D011310:Preservatives, Pharmaceutical; D011312:Pressure; D012965:Sodium Chloride; D013997:Time Factors
chemical_list: D006454:Hemoglobins; D011310:Preservatives, Pharmaceutical; D008353:Mannitol; D012965:Sodium Chloride; D007770:L-Lactate Dehydrogenase; D005947:Glucose; D000225:Adenine; D011188:Potassium