title: Erythrocyte storage in hypertonic (SAGM) or isotonic (PAGGSM) conservation medium: influence on cell properties.
abstract: OBJECTIVE
  Prolonged red blood cell (RBC) storage may be associated with increased post-transfusion morbidity and mortality. A contributing factor is RBC storage lesions. We analysed the role of additive conservation solutions, either hypertonic or isotonic, on such cell properties.
  
  
  METHODS
  After blood donation in citrate-phosphate-dextrose as an anticoagulant, 10 RBC units were stored with saline-adenine-glucose-mannitol (SAGM; 376 mOsm/l) and 10 units with phosphate-adenine-glucose-guanosin-saline-mannitol (PAGGSM; 285 mOsm/l). Measurements were made on days 1 and 42 of storage.
  
  
  RESULTS
  The mean cellular volume measured by centrifuged microhaematocrit increased from 87.6 +/- 3.1 fl to 100.7 +/- 4.3 fl in PAGGSM and to 92.2 +/- 2.5 fl in SAGM (P < 0.001) on day 1, after 42 days it was 95.8 +/- 4.0 fl and 93.8 +/- 3.9 fl, respectively. Spontaneous haemolysis and osmotic fragility were lower after storage in PAGGSM. Both additives showed a similar degree of echinocytosis, decreased RBC aggregability and deformability, and increased RBC suspension viscosity after storage.
  
  
  CONCLUSIONS
  The isotonic PAGGSM prevented the initial RBC swelling caused by citrate-phosphate-dextrose less than hypertonic SAGM, but reduced the spontaneous haemolysis rate and osmotic fragility after 42 days of storage. All other parameters, such as echinocytosis, decreased RBC deformability and aggregability, and increased blood viscosity was similar for both additive solutions and remained a major problem of blood banking.
authors.affiliation: Department of Internal Medicine, Kantonsspital Graubünden, Chur, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Zehnder
authors.forename: T
authors.initials: T
authors.lastname: Schulzki
authors.forename: J S
authors.initials: JS
authors.lastname: Goede
authors.forename: J
authors.initials: J
authors.lastname: Hayes
authors.forename: W H
authors.initials: WH
authors.lastname: Reinhart
mesh_terms: D001793:Blood Preservation / Q000379:methods*; D004912:Erythrocytes / Q000187:drug effects*; D005950:Glucose Solution, Hypertonic; D006461:Hemolysis / Q000187:drug effects; D006801:Humans; D006982:Hypertonic Solutions / Q000737:chemistry / Q000494:pharmacology*; D007552:Isotonic Solutions / Q000737:chemistry / Q000494:pharmacology*; D009996:Osmotic Fragility / Q000187:drug effects; D012462:Saline Solution, Hypertonic
chemical_list: D005950:Glucose Solution, Hypertonic; D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D012462:Saline Solution, Hypertonic