Feasibility of a new in vitro approach to evaluate cellular damage following co-infusion of red blood cell concentrates and intravenous drug solutions.
BACKGROUND
Transfusion guidelines may result in unwanted delay in infusion schemes, as simultaneous infusion of blood components and drug solutions is universally prohibited. The aim of this study was to measure possible damage to red cells by drug solutions, as manifested by haemolysis, using a dynamic model that resembles the clinical setting.


METHODS
Stored filtered and irradiated RBC concentrates and drug solutions were co-infused in an in vitro dynamic model. Also, incubation in a static model was performed. The haemolytic potency of the drug solutions was measured by determining free haemoglobin (fHb) levels.


CONCLUSIONS
Neither in the dynamic tests nor in the static tests did fHb levels exceed the maximally acceptable standard for filtered RBC concentrates according to Dutch specification guidelines. In the static test model, fHb levels were slightly elevated compared with those of control samples, as well as those in the dynamic test model.


CONCLUSIONS
A novel in vitro dynamic infusion system appears to represent a useful technique to calculate possible damage to RBCs resulting from co-infused drug solutions. Co-infusion of the drug solutions tested with filtered and irradiated RBC concentrates did not produce fHb levels above the levels accepted by the Dutch national guidelines. Apart from haemolysis, other parameters reflecting RBC damage should be investigated in future studies.
van den Bos
A
A
Department of Blood Transfusion and Transplantation Immunology, University Medical Centre, St Radboud, Nijmegen, The Netherlands. a.vandenbos@abti.umcn.nl
Wissink
W M
WM
Schattenberg
A V M B
AV
Werre
J M
JM
de Pauw
B E
BE
D064420:Drug-Related Side Effects and Adverse Reactions; D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000379:methods; D004912:Erythrocytes / Q000187:drug effects / Q000473:pathology*; D005240:Feasibility Studies; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D008955:Models, Cardiovascular; D004364:Pharmaceutical Preparations / Q000008:administration & dosage
D006454:Hemoglobins; D004364:Pharmaceutical Preparations