A comparative study of reducing the extracellular potassium concentration in red blood cells by washing and by reduction of additive solution.
BACKGROUND
Extracellular potassium concentration (K(+)) increases in the supernatant of whole and packed red blood cell units (pRBCs) with duration of refrigerated storage in citrate-phosphate-dextrose-adenine (CPDA-1) and additive solution (AS). Studies have shown that to avoid hyperkalemia, washed pRBCs are preferred if relatively fresh pRBCs are not available. To determine whether a simpler procedure, AS reduction, results in lowering of K(+) in pRBCs comparable to that achieved by washing, the K(+) levels by both methods were compared.


METHODS
Pre- and post-K(+) levels were measured in 6 washed and 11 AS-reduced pRBC units. Each unit was weighed, hematocrit was determined, K(+) was measured, and total K(+) was calculated. Washed units were 3 to 21 and AS-reduced units were 4 to 30 days old. Statistical analysis was performed with a t test.


RESULTS
There was no significant difference (p > 0.35) in the initial K(+) between the two groups (mean +/- SD, 36.95 +/- 13.16 mEq/L before washing and 39.78 +/- 19.94 mEq/L before AS reduction). Washing and AS reduction both led to a significant decrease in K(+) levels (2.15 +/- 0.10 mEq/L after washing and 4.41 +/- 3.04 mEq/L after AS reduction, each p < 0.0005). Washing, however, was significantly better than AS reduction in reducing K(+) in stored pRBCs (p < 0.05).


CONCLUSIONS
Washing pRBCs results in very low levels of K(+). AS reduction also significantly reduces K(+) levels. Selection of the method of K(+) reduction will depend on the stringency of K(+) reduction needed, the time constraints, and the availability of facilities and staff for washing.
Bansal
Ila
I
Department of Pathology (Blood Bank), The University of Chicago, Chicago, IL 60637, USA.
Calhoun
Beverly W
BW
Joseph
Cherilyn
C
Pothiawala
Mohammad
M
Baron
Beverly W
BW
D000094902:Blood Banking / Q000379:methods; D001793:Blood Preservation; D017707:Erythrocyte Transfusion / Q000379:methods*; D004912:Erythrocytes / Q000378:metabolism*; D006801:Humans; D006947:Hyperkalemia / Q000517:prevention & control*; D011188:Potassium / Q000097:blood*; D012996:Solutions
D012996:Solutions; D011188:Potassium