title: Coinfusion of dextrose-containing fluids and red blood cells does not adversely affect in vitro red blood cell quality.
abstract: BACKGROUND
  Transfusion guidelines advise against coinfusing red blood cells (RBCs) with solutions other than 0.9% saline. We evaluated the impact of coinfusion with dextrose-containing fluids (DW) on markers of RBC quality.
  
  
  METHODS
  A pool-and-split design was used to allow conditions to be tested on each pool within 2 hours of irradiation. Three pools at each storage age (5, 14, and 21 days) were created for each phase. In Phase 1, samples were infused through a neonatal transfusion apparatus alone or with treatment solutions: D5W, D10W, D5W/0.2% saline, and 0.9% saline. In Phase 2, samples were incubated alone or in a 1:1 ratio with treatment solutions and tested after 5, 30, and 180 minutes. Hemolysis, supernatant potassium, RBC indices, morphology, and deformability were measured on all samples.
  
  
  RESULTS
  In Phase 1, RBCs transfused alone through the apparatus had higher (p<0.01) hematocrit, total hemoglobin, and supernatant potassium compared to all other groups. No statistical differences were identified between groups for other measured variables. In Phase 2, mean corpuscular volume of all samples containing DW increased with incubation length and were higher (p<0.01) than RBCs incubated alone or with 0.9% saline after 30 and 180 minutes. RBCs incubated with D5W and D5W/0.2% saline had greater (p<0.05) hemolysis than RBCs alone after 180 minutes.
  
  
  CONCLUSIONS
  In vitro characteristics of RBCs coinfused with 0.9% saline or D10W were not adversely impacted. When developing clinical studies in neonates, we recommend use of D10W and a transfusion apparatus that minimizes the contact volume of the coinfusate with the RBC.
authors.affiliation: Division of Neonatology, Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
authors.forename: Amy K
authors.initials: AK
authors.lastname: Keir
authors.forename: Adele L
authors.initials: AL
authors.lastname: Hansen
authors.forename: Jeannie
authors.initials: J
authors.lastname: Callum
authors.forename: Robert P
authors.initials: RP
authors.lastname: Jankov
authors.forename: Jason P
authors.initials: JP
authors.lastname: Acker
mesh_terms: D001803:Blood Transfusion / Q000295:instrumentation / Q000379:methods*; D004353:Drug Evaluation, Preclinical; D004907:Erythrocyte Deformability / Q000187:drug effects; D004909:Erythrocyte Indices / Q000187:drug effects; D004912:Erythrocytes / Q000187:drug effects*; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology*; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D066298:In Vitro Techniques; D015931:Intensive Care, Neonatal / Q000379:methods*; D009994:Osmolar Concentration; D009996:Osmotic Fragility; D011188:Potassium / Q000097:blood; D017410:Practice Guidelines as Topic; D012965:Sodium Chloride / Q000494:pharmacology; D012996:Solutions / Q000494:pharmacology
chemical_list: D006454:Hemoglobins; D012996:Solutions; D012965:Sodium Chloride; D005947:Glucose; D011188:Potassium