A Study of the Change in Sodium and Potassium Ion Concentrations in Stored Donor Blood and Their Effect on Electrolyte Balance of Recipients

Abstract

Background Preserved blood cells undergo progressive structural and functional changes that may affect their function, integrity, and viability after transfusion. The impact of transfusion of stored blood on potassium, sodium, or acid-base balance in the recipient may be complex, but information on it is inconsistent. This study therefore sought to determine the changes in the potassium and sodium levels in whole blood stored at 4°C for 28 days and clinical outcomes when such blood are transfused. Methods Whole blood were taken into double CPDA-1 bags and 50 ml transferred into the satellite bags for the study. Electrolyte concentration determinations were made on each of the blood sample on days 0, 7, 14, 21, and 28 using the Vitalab Selectra Junior chemistry analyser. The remaining blood in the main bags was transfused after the 28-day period, and biochemical analysis carried out on the patients before and after the transfusion. One-way ANOVA was used for the analysis of variance between the weekly ion concentrations and independent sample Mann–Whitney U test for the data obtained from the patients. Results The mean potassium level of all the samples started with a normal value of 3.45 mmol/L on the first day followed by a sharp rise to 9.40 mmol/L on day 7, 13.40 mmol/L on day 14, 14.60 mmol/L on day 21, and 15.40 mmol/L on day 28. Sodium on the other hand started with a high value of 148.4 mmol/L on day 0 and then reduced to 146.4 mmol/L on day 7, 140.8 mmol/L on day 14, 135.6 mmol/L on day 21, and a low value of 130.8 mmol/L on day 28. No adverse clinical outcomes were seen in patients after they were transfused with the blood. Conclusion It can be deduced that potassium concentration in refrigerated blood increases, whilst sodium concentration reduces with time and when such blood is transfused, it may not result in any adverse clinical outcome.

The relationship of membrane stiffness, cytoskeleton structure and storage time of pRBCs

“…Oxidative processes, as noted by other researchers, can stimulate lipid peroxidation, protein Band 3 clustering, [14,25,26], discontinuities in cytoskeleton filaments, polymerization and aggregation of the protein structures of the matrix network [27]. In our study, extracellular К + concentration increased up to 10–12 m m (3·4 m m initially) due to violations of the lipid bilayer membrane, lactate increased and glucose decreased, which is consistent with other studies [3,28–30]. Such changes at the molecular level can cause impairments in the cytoskeleton structure and increasing of E during storage of pRBCs observed by us (Figs.…”

Post-Exchange Transfusion Sodium Change Within a Laboratory Reference Range of Serum in Hospitalized Severe Neonatal Jaundice Cases

“…This potentially emergency practice is regularly utilized in term infants for suppressing the occurrence of acute bilirubin encephalopathy (ABE), kernicterus features, and death (20). Reversible electrolyte imbalances, especially natural serum sodium and potassium disturbances, are the two most increasingly frequent abnormalities that are referred for administration of ECT therapy (14). To the best of the authors' knowledge, there are a few conducted quantitative and qualitative surveys for determining and improving the increased risk of detrimental clinical outcomes correlated with possible fatal abrupt changes in sodium during and after the exchange transfusion in newborns.…”

“…Many previous studies have reported that the most important reason of the apparent sodium ion concentration change near the upper limit of standard value in most cases, during and after exchange blood transfusion, is poor nutrition in the first several days of life that leads to physiological loss of extracellular fluid's volume, body water imbalance, and dehydration (5,(12)(13)(14). Additionally, serum sodium ion concentration disturbances following administration of an extensive quantity of stored blood products, which are typically sodium bicarbonate-rich solutions, could be deduced as poor prognosis of renal failure (15,16).…”

Effect of Leukoreduction on Hematobiochemical Parameters and Storage Hemolysis in Canine Whole Blood Units

“…SLs are responsible for negative post-transfusion effects in recipients, particularly in critically ill patients, and are classified into three categories: biochemical, biomechanical or morphological, and immunological changes [ 4 ]. Particularly, biochemical changes include the increase of potassium and sodium and hemolysis and oxidative injury [ 1 , 2 , 5 , 6 , 7 , 8 ]; biomechanical or morphological modifications include shape alterations and a reduction of RBC deformability. The modifications related to the corpuscular components of blood units could relate to RBC, white blood cells (WBCs) and platelets (PLTs).…”

“…The modifications related to the corpuscular components of blood units could relate to RBC, white blood cells (WBCs) and platelets (PLTs). Those related to RBCs are oxidative injury [ 7 ], hemolysis [ 2 , 6 ], morphological alterations and changes in membrane composition [ 1 ], changes in sodium and potassium levels [ 1 , 5 , 8 ], and the release of procoagulant microparticles [ 9 , 10 ]; those connected to WBCs and PLTs are the increase in interleukin (Il-8) and VEGF [ 11 , 12 , 13 ], and the release of procoagulant phospholipid (PPL) [ 14 ] and microparticles [ 15 ].…”