Effect of varying external pneumatic pressure on hemolysis and red blood cell elongation index in fresh and aged blood

Abstract

Background:External applied pneumatic pressure is usually used for rapid transfusion of red blood cells (RBCs). However, increased shear stress can cause increased hemolysis and decreased RBC elongation indices. Therefore, the purpose of this study was to measure the degree of hemolysis and the alteration of RBC elongation indices under varying external pressure in fresh and aged blood.Methods:Venous blood samples were obtained from 20 healthy human volunteers. Each blood bag was divided into 2 subgroups (5 or 35 days of storage), and 5 levels of pressure were applied: 0, 150, 200, 250, and 300 mmHg. After infusion, a laboratory study was conducted. The percentages of irreversibly changed cells were evaluated using Bessis classification. RBC elongation indices were measured using a microfluidic ektacytometer.Results:There were no significant differences in the percentage of irreversibly changed RBCs between the pressures of 0 and 300 mmHg. Moreover, there were no significant differences in laboratory test results or elongation indices among all levels of pressure. Irreversibly changed RBCs and hemolysis were increased depending on the storage period.Conclusion:Irreversible changes in RBCs did not occur as a result of external pressure. The hemolysis and elongation indices of fresh RBCs were not influenced by external pneumatic pressure up to 300 mmHg. Only the storage period affected the irreversible changes in RBCs and hemolysis. Therefore, the application of external pressure to RBCs in variously aged blood is likely to be a safe procedure.

Transfusion Practice

“…In studies using a system of gravitational equipment for blood transfusion subjected to external pneumatic pressure of 150 to 300 mmHg, degree of hemolysis presented no statistical significance in the association with pressure levels 52,53 ; however, in the highest pressure parameter applied, it presented a progressive decrease of K, 53 a behavior like that evidenced in the current study at a higher rate, but with significant statistical influence. Studies have compared gravitational infusion with other methods of administering RBCs through electronic devices.…”

Evaluation of a rail logistics transmission system for the transportation of blood components within a medical centre

“…As is well known, pRBC samples stored in blood bank conditions undergo a progressive series of physical and biochemical alterations known as RBC storage lesions [20, 21]. There is no doubt that a variety of factors, for example, vibrations, pressure and rapid accelerations, collectively exacerbate the aggravation of the structure, cell viability and microcirculatory flow of aged RBCs [22]. Our results showed that aged RBCs transported by RLTS do not exhibit a significant increase in the HI or LDH and K + levels in plasma (Figure 2).…”

Influence of Peripherally Inserted Central Catheters With Proximal Valves on Red Blood Cell Hemolysis During Transfusion

“…This action reduces device diameter and subjects cells to a higher pressure with consequent erythrocyte damage. 26 In the infusions of PRBCs at a minimum rate, hemolysis is related to longer exposure of cells to shear stress, because the infusion occurred more slowly. 27 A study with nonvalved PICCs showed a significant change in the levels of hemolysis markers after infusion flow control, in 3F PICCs, with a lower infusion rate.…”

“…The variation in hemolysis markers between the FFA and CFA may be related to the infusion rate through partial closure of the roller clamp of the gravity-driven drop infusion device. This action reduces device diameter and subjects cells to a higher pressure with consequent erythrocyte damage 26. In the infusions of PRBCs at a minimum rate, hemolysis is related to longer exposure of cells to shear stress, because the infusion occurred more slowly 27.…”

“…The increase in pressure inside the catheter can be related to hemolysis. Researchers report that shear stress is dependent on external pressure applied to the cells, viscosity, and type of fluid flow 12,26,28,29. Thus, high pressure can be associated with the occurrence of increased shear stress and, consequently, hemolysis mainly at higher infusion rates.…”