title: Reducing the risk of hyperammonemia from transfusion of stored red blood cells.
abstract: Ammonia concentration increases in red cell units (RBCs) during storage. We measured absolute amounts of ammonia (AA) per unit serially in stored RBCs and before and after removal of the supernatant by volume reduction (VR) or washing. Ammonia increased 6.4-fold in untreated units over 31 days. VR decreased AA 3.7-fold, whereas washing decreased it 38-fold (p<0.0001). At least for certain patients, e.g., infants receiving large volume transfusions and patients in liver failure, it may be advisable to use RBCs as fresh as possible and to limit infusion (by VR or washing) of ammonia in the supernatant.
authors.affiliation: Department of Pathology, The University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA.
authors.forename: Marsha
authors.initials: M
authors.lastname: Apushkin
authors.forename: Anne
authors.initials: A
authors.lastname: Das
authors.forename: Cherilyn
authors.initials: C
authors.lastname: Joseph
authors.forename: Edward Ki Yun
authors.initials: EK
authors.lastname: Leung
authors.forename: Kiang-Teck J
authors.initials: KT
authors.lastname: Yeo
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Baron
authors.forename: Beverly W
authors.initials: BW
authors.lastname: Baron
mesh_terms: D000641:Ammonia / Q000097:blood; D001793:Blood Preservation / Q000379:methods*; D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000379:methods; D004912:Erythrocytes; D006801:Humans; D022124:Hyperammonemia / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000641:Ammonia
keywords: Ammonia during red cell storage; Ammonia in red cell units; Ammonia reduction by volume reduction of RBCs; Ammonia reduction by washing RBCs