Can Ringer's lactate be used safely with blood transfusions?
BACKGROUND
Blood bank recommendations specify that Ringer's lactate solution (LR) should be avoided while transfusing blood. However, there are few studies either evaluating or quantifying increased coagulation during rapid infusion of LR and blood.


METHODS
Whole blood (WB, n = 25) and packed red blood cells (PRBC, n = 26) were rapidly admixed with normal saline (NS), Lactate solution and LR with 1 g (LR-1), 2 g (LR-2), and 5 g (LR-5) CaCl2/L solutions for assessment of infusion time, filter weight, and clot formation.


RESULTS
No significant differences in infusion time or filter weight using WB or PRBC with NS or LR were seen. No significant difference in clot formation between NS and LR with WB or PRBC was found, but the presence of visible clot was increased in the LR-5 group (P = 0.013, WB, and P = 0.002, PRBC).


CONCLUSIONS
A comparison of LR and NS with rapid infusion rates of blood showed no significant difference between infusion time, filter weight and clot formation. Blood bank guidelines should be revised to allow the use of LR in the rapid transfusion of PRBC.
Lorenzo
M
M
Department of Surgery, University of California, San Francisco/Fresno Valley Medical Center, USA.
Davis
J W
JW
Negin
S
S
Kaups
K
K
Parks
S
S
Brubaker
D
D
Tyroch
A
A
D001777:Blood Coagulation; D001803:Blood Transfusion / Q000379:methods*; D017707:Erythrocyte Transfusion / Q000379:methods; D006801:Humans; D007552:Isotonic Solutions / Q000009:adverse effects*; D000077325:Ringer's Lactate; D012965:Sodium Chloride; D014462:Ultrafiltration
D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012965:Sodium Chloride