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dc.contributor.authorPires, Maria Paula Oliveira
dc.contributor.authorPeterlini, Maria Angélica Sorgini
dc.contributor.authorUllman, Amanda J
dc.contributor.authorBulmer, Andrew C
dc.contributor.authorRickard, Claire M
dc.contributor.authorPedreira, Mavilde Luz Gonçalves
dc.description.abstractBACKGROUND: Transfusion of red blood cell (RBC) concentrates is a common procedure to restore blood volume and tissue oxygen delivery in patients with trauma. Although RBC warmers may prevent hypothermia, some warming or infusion equipment may lead to haemolysis and patient injury. OBJECTIVES: The aim of this study was to test the effect of (i) RBC warming and (ii) administration via manual vs. pump infusion on haemolysis. METHODS: This experimental ex vivo study studied haemolysis markers of RBC injury. The sample consisted of 90 RBC infusions in two simulations, randomly, 45 warmed RBC infusions and 45 nonwarmed RBC infusions, in two or three stages: before the intervention (baseline-warming, N= 45; nonwarming, N= 45), after water bath warming at 42 °C (warmed, N= 45), and then after the warmed or nonwarmed RBCs were infused by manual or pump infusion at a rate of 100 mL/h (infusion-warming, N= 45; nonwarming, N= 45). RESULTS: Warmed RBCs showed significantly lower total haemoglobin (Hb) and haematocrit levels and increase in free Hb levels, haemolysis levels, and lactate dehydrogenase (LDH) activity (all p<0.05) than baseline RBCs. Pump infusion RBCs were associated with reduced total Hb and increased free Hb, haemolysis, and potassium (K) levels (all p<0.05) compared with warmed RBCs. In contrast, manual infusion of warmed RBCs resulted in significantly reduced total Hb levels and increased LDH activity (both <0.05). After infusion, total Hb, free Hb, haematocrit, haemolysis, and LDH values were significantly different for warmed vs. nonwarmed RBCs (p<0.05). CONCLUSIONS: Haemolysis biomarkers increase with RBC warming and infusion, especially when using infusion pumps. Critically ill patients should be carefully monitored for possible complications during and after RBC infusion.
dc.relation.ispartofjournalAustralian Critical Care
dc.subject.fieldofresearchClinical Sciences
dc.subject.keywordsBlood transfusion
dc.subject.keywordsHypothermia: prevention
dc.titleEffect of warming and infusion of red blood cell concentrates on markers of haemolysis: An ex vivo simulation study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationPires, MPO; Peterlini, MAS; Ullman, AJ; Bulmer, AC; Rickard, CM; Pedreira, MLG, Effect of warming and infusion of red blood cell concentrates on markers of haemolysis: An ex vivo simulation study, Australian Critical Care, 2020
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.
gro.hasfulltextNo Full Text
gro.griffith.authorRickard, Claire
gro.griffith.authorUllman, Amanda J.
gro.griffith.authorPedreira, Mavilde
gro.griffith.authorBulmer, Andrew C.

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