Polyethylene Glycol Additives Reduce Hemolysis in Red Blood Cell Suspensions Exposed to Mechanical Stress

Abstract

Mechanical damage to blood cells is of considerable concern in the development and use of circulatory assist devices and other blood contacting systems. Furthermore, hemodilution with saline, dextran, and other plasma expanders applied during extracorporeal circulation and dialysis increases red blood cell (RBC) susceptibility to the high shear stresses associated with these procedures. In this paper, we present polyethylene glycol (PEG) as a potential erythrocyte protective agent against mechanically induced cellular trauma. Bovine RBCs were subjected to mechanical stress induced by rolling stainless steel shots through RBC suspensions for a constant exposure time. The suspensions were prepared at a hematocrit of 30% in various media: PEG (20,000 molecular weight), autologous bovine plasma, Dextran 40 solution, and phosphate buffered saline (PBS). RBC suspensions in Dextran 40 were prepared at a viscosity similar to the PEG suspensions. We found the hemolysis level of RBCs suspended in plasma and in PEG solutions to be several times lower (p < 0.001) than in the Dextran and PBS solutions. No statistically significant difference was found between the hemolysis that occurred in suspensions of RBCs in autologous plasma and in 2.0% PEG solutions. Even PEG concentration as low as 0.1% reduced hemolysis by more than 40% compared with PBS or the same concentration of Dextran in suspension medium. Our data demonstrate the efficacy of PEG molecules in reducing mechanical trauma to erythrocytes and suggest the potential for using PEG in assisted circulation, dialysis, and other procedures where RBCs are subjected to extensive mechanical stress.

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“…Thus, hemolytic index ranging between 0 and 2% are considered as non-hemolytic while ranging 2–5% are slight hemolytic, and < 5% are classified as hemolytic ones (Pires et al 2018 ). Similar results were obtained by Kameneva et al ( 2003 ) where the PEG contact (any molecular weight) reduced the hemolysis rate of erythrocytes. Shih et al ( 2011 ) also reported that PEG addition to the poly(hexa-methylene-urethane) resulted the lowering of hemolysis as the compatibility with blood is improved.…”

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Mechanical Blood Trauma in Assisted Circulation: Sublethal RBC Damage Preceding Hemolysis

“…Effect of suspension media with matched viscosities on bovine RBC mechanical fragility, highlighting the protective effects of plasma proteins and PEG versus Dextran-40 solution, adapted from Kameneva et al (72). …”