title: Correction of blood coagulation dysfunction and anemia by supplementation of red blood cell suspension, fresh frozen plasma, and apheresis platelet: results of in vitro hemodilution experiments.
abstract: OBJECTIVE
  This study aimed to determine the optimal composition and timing for the administration of blood supplements during in vivo blood transfusion with red blood cells suspension (pRBC), fresh frozen plasma (FFP), and apheresis platelet (PLT) administered for the correction of anemia and coagulation dysfunction caused by in vitro hemodilution.
  
  
  METHODS
  We collected blood samples from 24 healthy volunteers and prepared various dilutions of whole blood with normal saline: 9:1, 8:2, 7:3, 6:4, 5:5, 4:6, 3:7, 2:8, and 1:9. The diluted blood samples were then supplemented with blood components at various proportions and then analyzed to determine the values of the routine blood indices, coagulation indices, and thromboelastogram measures.
  
  
  RESULTS
  At hemodilutions of 40%, 50%, and 60%, the hemoglobin, coagulation indices, and platelet number and function reached critical levels, necessitating supplementation with pRBC, FFP, and PLT, respectively. When hemodilution was 90%, the supplementation required was approximately 1:1.3:0.9 of pRBC/FFP/PLT.
  
  
  CONCLUSIONS
  The use of pRBC, FFP, and PLT in appropriate proportions can correct the blood coagulation dysfunction and anemia caused by in vitro hemodilution, and these proportions can be used as guidelines for in vivo massive transfusion.
authors.affiliation: Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, China. Electronic address: yjc65@sina.com.
authors.forename: Jiangcun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Dermatology, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
authors.forename: Qianli
authors.initials: Q
authors.lastname: Dang
authors.affiliation: Shaanxi Provincial Center for Clinical Laboratory, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
authors.forename: Cuixiang
authors.initials: C
authors.lastname: Xu
authors.affiliation: Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Ma
authors.affiliation: Department of Laboratory, Shaanxi Provincial People's Hospital, Xi'an 710068, China. Electronic address: renjiankan123@163.com.
authors.forename: Jiangkang
authors.initials: J
authors.lastname: Ren
mesh_terms: D000740:Anemia / Q000209:etiology / Q000628:therapy*; D001777:Blood Coagulation / Q000502:physiology; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000628:therapy*; D001781:Blood Component Removal / Q000379:methods*; D001792:Blood Platelets / Q000502:physiology*; D001803:Blood Transfusion / Q000379:methods; D017707:Erythrocyte Transfusion / Q000379:methods*; D004912:Erythrocytes; D006438:Hemodilution / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D066298:In Vitro Techniques; D010949:Plasma; D010976:Platelet Count; D013916:Thrombelastography
keywords: Disturbance of blood coagulation; Fresh frozen plasma; Hemodilution; Red blood cells suspension; Thrombelastogram