title: Effect on the quality of blood components after simulated blood transfusions using volumetric infusion pumps.
abstract: BACKGROUND
  It is unknown whether the use of volumetric infusion pumps for the transfusion of red blood cells (RBCs) or platelet (PLT) concentrates (PCs) affects the quality of the blood components. We therefore investigated the in vitro quality of these components after use of infusion pumps.
  
  
  METHODS
  Ten different volumetric infusion pumps were used to simulate transfusion with RBCs and PCs. To prevent donor-dependent differences multiple units were pooled and divided into equal portions. The storage time of RBCs was 30 to 35 days (n=10 experiments), and for PCs, either 2 (n=5) or 7 days (n=5). For RBCs an infusion rate of 100 or 300mL/hr was used, and for PCs, 600mL/hr. Transfusions without an infusion pump served as a reference.
  
  
  RESULTS
  None of the infusion pumps induced an increase of free hemoglobin, annexin A5 binding, or formation of echinocytes in RBCs compared to reference units. In 2- and 7-day-old PCs no effect was shown on PLT concentration, annexin A5 binding, mean PLT volume, and morphology score compared to the reference. The CD62P expression of 2-day-old PCs was significantly lower after transfusion compared to the reference, that is, 11.7±2.1% versus 8.1±1.3% (p<0.01).
  
  
  CONCLUSIONS
  There was no adverse effect on the in vitro quality of RBCs or PCs after simulated transfusion using volumetric infusion pumps. A decrease in PLT activation was observed, which can probably be explained by capturing of activated or damaged PLTs in the 200-µm filter present in the infusion system.
authors.affiliation: Sanquin Blood Supply Foundation, Blood Bank Region North West, Amsterdam, The Netherlands. r.lieshout@sanquin.nl
authors.forename: Ryanne W
authors.initials: RW
authors.lastname: Lieshout-Krikke
authors.forename: Pieter F
authors.initials: PF
authors.lastname: van der Meer
authors.forename: Maria M W
authors.initials: MM
authors.lastname: Koopman
authors.forename: Dirk
authors.initials: D
authors.lastname: de Korte
mesh_terms: D017304:Annexin A5 / Q000378:metabolism; D016913:Blood Component Transfusion / Q000379:methods* / Q000592:standards*; D001783:Blood Flow Velocity; D058731:Blood Safety; D001810:Blood Volume / Q000502:physiology; D003198:Computer Simulation; D004912:Erythrocytes / Q000166:cytology / Q000378:metabolism; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007260:Infusion Pumps; D008422:Materials Testing / Q000379:methods; D011786:Quality Control; D012212:Rheology
chemical_list: D017304:Annexin A5; D006454:Hemoglobins