Influence of transfusion technique on survival of autologous red blood cells in the dog

Abstract

Objective To determine the effect of 3 differing transfusion techniques on survival of autologous canine red blood cells (RBCs). Design Prospective, blinded study. Setting University Teaching Hospital. Animals Nine healthy dogs. Interventions Three distinct preparations of RBCs, each representing ∼1% of red cell mass, were generated for each dog by biotinylation of RBCs at varying biotin densities. Labeled cells were transfused using 3 techniques (gravity, volumetric pump, syringe pump). Serial determinations of red cell survival were carried out by flow-cytometric analysis of RBCs collected at 7-day intervals for 49 days. In vitro analysis of the effect of transfusion methods on RBC integrity and osmotic fragility were carried out in 7/9 dogs. Measurements and Main Results RBCs administered via volumetric and syringe pumps exhibited a marked decrease in short-term probability of survival compared to RBCs delivered by gravity flow. At 24 hours, only 4/8 and 1/7 dogs had surviving cell populations delivered by volumetric and syringe pump respectively, compared with 8/8 dogs which had surviving cell populations delivered by gravity flow. Circulating half-life of cells surviving at 24 hours after delivery by volumetric pump was not significantly different to that delivered by gravity flow . No significant effect on in vitro RBC integrity or osmotic fragility was detected in relation to transfusion technique. Conclusions Delivery of autologous canine RBCs via mechanical delivery systems was associated with a high risk for early loss of transfused cells.

Influence of cross‐match on posttransfusion packed cell volume in feline packed red blood cell transfusion

“…The method of blood product administration has recently been investigated in dogs, and the use of mechanical delivery systems was associated with early loss of transfused RBCs. 34 Syringe and fluid pumps are commonly used to regulate the speed of pRBC transfusions in our practice, and the use of these devices may have resulted in less effective transfusions. Because the method of delivery is not routinely documented in our pRBC transfusion records, evaluation of delivery technique was not possible, although it is unlikely that there were differences in method of delivery between the two groups of cats.…”

Hematologic Disorders

“…Compared to administration by gravity flow, RBCs administered by volumetric or syringe pump may undergo more shear stress, which may cause lysis or decreased survival of the transfused cells. 21 In emergent scenarios, blood may be given rapidly either using a pressure infusion bag or by attaching an in-line three-way stopcock and 60-ml syringe to pull blood from the unit and then rapidly infuse it into the patient. In scenarios such as these, with severe hemorrhage, the replacement of coagulation factors with fresh frozen plasma (FFP) is frequently indicated, and the plasma may be used along with crystalloid and colloid fluids to maintain intravascular volume.…”

Blood transfusion methods: time to reevaluate?

“…McDevitt, Ruaux, and Baltzer address this important aspect of transfusion 9 . In their article entitled ‘Influence of transfusion technique on survival of autologous red blood cells in the dog,’ they evaluated cell survival using different transfusion pump methods, including simple gravity, volumetric, and syringe pumps 9 . This study evaluated a novel aspect of blood transfusion, that is, the effect of the administration technique on RBC survival posttransfusion.…”

“…The reported survival rate of transfused cells in the study by Wardrop et al 13 was approximately 80%. This current study by McDevitt et al 9 is unique, as it evaluated cell survival following 3 clinically common transfusion methods, and found that gravity‐delivered transfusions were associated with a marked increase in cell survival. While this study was plagued with technical complications that limited the sample size, it still has important implications for the practicing veterinarian and technician.…”

“…As highlighted in this study, 9 current beliefs regarding the ideal transfusion technique are largely based in expert opinion as well as ease of administration. This study provides compelling evidence to further investigate the outcome of transfusion technique on clinical outcome, and at the very least is a strong argument for adding the transfusion technique to the medical record.…”