Biochemical changes in whole blood stored for transfusion at Bungoma County Referral Hospital, Kenya

Abstract

Background During storage, transfusion blood may undergo a series of biochemical changes that could pose risks to patients when used. It is important therefore to monitor biochemical changes that may reduce survival or function of stored blood cells. Objective This study assessed biochemical changes in whole blood stored for transfusion at Bungoma County Referral Hospital in the western region of Kenya between February 2019 and August 2019. Methods A prospective study design involving 20 randomly selected donor blood units in citrate phosphate dextrose adenine anticoagulant was employed. Biochemical changes were evaluated for 35 days. Potassium and sodium levels were tested using the HumaLyte Plus5 analyser. Blood pH level was estimated using the Hanna pH meter. Results At the end of the 35 days of storage under blood bank conditions, the mean potassium level significantly increased from 7.31 mmol/L at baseline to 20.14 mmol/L at week 5 ( p < 0.0001), and the mean sodium level significantly decreased from 150.72 mmol/L at baseline to 121.56 mmol/L at week 5 ( p < 0.0001). The pH level decreased insignificantly from 7.48 at baseline to 7.38 at the end of week 1 ( p = 0.0757) but decreased significantly to 6.15 at the end of week 5 ( p < 0.0001). Conclusion Potassium increased and sodium concentrations decreased significantly from the first week of blood storage. The pH decreased significantly from the second week of storage. Therefore, aged blood should be avoided to circumvent potential adverse outcomes from biochemical changes and stored blood should be tested before use.

A Study on Biochemical Changes of Lactate, Potassium, and Sodium in Stored Blood Units

“…Haemoglobin level estimation demonstrated a slight decrease from day 0 to Day 28 (from 14.2±1.7 to 12.1±1.4) similar to several previous studies (7,8). A study recorded a slight increase in Hemoglobin levels.…”

“…A significant decrease of WBC was observed from Day 0 to Day 28 i.e. 7.6 The present study also showed a decrease in mean RBC count from 1st day to the 28th day which is to a study done by Marabi PM et al, 2020; Chaurasiya AK et al, 2022; Shrivastava P, Dutta S 2020; (7,8,10). In contrast to the findings of our study, Batham N. et al recorded no significant elevation in RBC count during the storage of 35 days (11).…”

“…A few homeostasis mechanisms are required to maintain the movement of potassium and sodium between the extracellular and intracellular environments. According to recent studies, potassium efflux, a well-known consequence of extended red blood cell reserve causes vesicle formation and could have a big impact on the outcome of the transfusion (7) (14)(15)(16)(17)(18). This study's significant increase in potassium may be caused by the slow and continuous release of potassium ions from cells into the surrounding plasma during storage.…”

“…www.worldwidejournals.com individuals who are seriously ill such as severe myocardial infarction etc. When compared to patients who received fresh blood, they found that patients who received extensively preserved blood had a higher rate of death, morbidity, infections, renal and lung collapse, oedema, and thrombosis (7).…”

“…Clinical studies have suggested that blood units kept in reserve for long periods (typically described as 14-21 days) may be harmful to patients, increasing their risk of morbidity and mortality (3). However, it has been suggested that an extended period of blood storage before a transfusion increases the possibility of complications.…”