Infusion pumps and red blood cell damage in transfusion therapy: an integrative revision of the academic literature

Wilson, Ana Maria Miranda Martins; Peterlini, Maria Angélica Sorgini

doi:10.1590/1518-8345.1155.2763

Cited by 16 publications

(27 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Infusion pump administration has been evaluated for iatrogenic hemolysis in numerous studies 7,9,12 . Peristaltic‐type infusion pumps, like the one used in this study, have been deemed safe for blood product administration in a recent review 9 . Results of the present study support this conclusion, revealing minimal in vitro iatrogenic hemolysis of canine blood at maximal infusion rates.…”

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

“…Overzealous crystalloid administration may also lead to dilutional coagulopathy and worsening acidosis 3 . Massive transfusion protocols that ensure use of sufficient blood products are part of a multimodal approach to damage control resuscitation, which decrease mortality in hemorrhaging human trauma patients 4 There are numerous studies assessing different methods of rapid transfusion 5–10 and associated RBC damage. However, rapid infusion techniques have not yet been compared in veterinary medicine, so the comparable risk factors for hemorrhaging veterinary patients are unknown.…”

Section: Introductionmentioning

confidence: 99%

“…Over time, RBC fragility leads to hemolysis and release of plasma free hemoglobin (fHb) and formation of microparticles 13–18 . The biochemical and biomechanical changes that occur over time are known as the RBC storage lesion, which is characterized by increasing concentrations of plasma fHb, microparticles, % hemolysis, osmotic fragility, serum potassium, total bilirubin, and lactate dehydrogenase and decreased nitric oxide availability, hematocrit, average corpuscular volume, total hemoglobin, and number of erythrocytes 5–7,9,10,12–18 . Hemolysis of blood products that occurs during the storage or transfusion process is a known risk factor for adverse transfusion‐related patient outcomes in people 13,14,19,20 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

In vitro iatrogenic hemolysis of canine packed red blood cells during various rapid transfusion techniques

Weeks¹,

Motsinger‐Reif

Reems³

2020

J Vet Emergen Crit Care

View full text Add to dashboard Cite

Objective To evaluate which rapid blood administration technique causes the least iatrogenic hemolysis in canine packed red blood cells (pRBCs) as determined by plasma free hemoglobin (fHb) and percent hemolysis (% hemolysis). Design Prospective in vitro randomized study. Setting Private referral center. Animals None. Interventions Thirteen units of canine pRBCs were divided equally into 5 aliquots, resulting in 65 trials. The aliquots of each unit were subjected to the following administration techniques: gravity‐driven (control), an infusion pump at maximal rate, application of a pressure bag, manual compression, and syringe bolus. Plasma fHb and % hemolysis were recorded before and after each trial. Rate of administration (mL/s) was calculated for each method. Measurements and main results Compared to the control, there were no significant increases in % hemolysis or plasma fHb noted among any of the trial methods. The manual compression and syringe bolus methods resulted in the fastest transfusion rates, whereas the infusion pump was not faster than the gravity‐driven method. Despite a storage time of ≤14 days, 15% of pRBC units had unsuitable (>0.8%) hemolysis before even being subjected to the trials. Conclusions Commonly used rapid infusion techniques in small animal transfusion medicine do not cause significant iatrogenic hemolysis of canine pRBCs in vitro, although a significant risk is present in stored blood. This suggests that if an expedited transfusion is needed, any method described in this study could be considered, although stored pRBCs should be tested for unsuitable levels of hemolysis prior to transfusion.

show abstract

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

In vitro iatrogenic hemolysis of canine packed red blood cells during various rapid transfusion techniques

Weeks¹,

Motsinger‐Reif

Reems³

2020

J Vet Emergen Crit Care

View full text Add to dashboard Cite

show abstract

“…However, drawbacks such as blood hemolysis, mechanical tubing degradation, and variable flow accuracy due to changing flow conditions are inherent to this approach (Bahal & Romansky, 2002;Pronk Technologies, 2020;Stull et al, 1988;Wilson et al, 2016). The Ivenix pump uses a pneumatically driven silicone diaphragm to pull fluid from a bag, fill an internal chamber, and then push the fluid to through tubing toward the patient as shown in Figure 2.…”

Section: By Eric a Smith And George Graymentioning

confidence: 99%

Developing a Smart Infusion Pump Dedicated to Infusion Safety

Smith¹,

Gray²

2020

Ergonomics in Design

View full text Add to dashboard Cite

A large-volume infusion pump is a medical device with a big job: infuse patients with life-sustaining fluids and medications at a known and controlled rate. And, do it safely. Because infusions are frequently administered therapies, the opportunity for use error–induced adverse events is amplified. To develop a safer infusion pump, Ivenix, Inc., committed to a comprehensive usability engineering effort that included over 400 hours of usability testing. As a result, the pump’s design includes risk controls for mitigating potential use errors not available on today’s pumps. The resulting product was the winner of the 2019 Stanley Caplan User-Centered Design Award.

show abstract