Red cell damage after pumping by two infusion control devices (Arcomed VP 7000 and IVAC 572)

Abstract

The aim of this study was to assess the performance in terms of red cell damage of two peristaltic volumetric infusion pumps - the Alaris IVAC 572 (San Diego, CA, USA) and Arcomed Volumed VP7000 (Regensdorf, Switzerland). Various infusion pumps are available to transfuse blood at a predetermined rate. It is recommended that each machine should be individually assessed. This experiment used six units of single-donor-transfusable packed red cells and ran each unit through both pumps. This was carried out at 9, 28 and 35 days post-donation at rates from 2 to 150 mL h(-1). Post-pumping samples from these experiments, and a pre-pumping sample in each case, were analysed for levels of potassium and free haemoglobin (Hb). They were also examined microscopically for evidence of cell damage. Potassium levels showed no significant change with pumping on any occasion, but rose significantly as the samples aged. Free Hb showed some variation, but the only consistent finding was a similar rise in value with increasing pack age. Microscopic examination revealed no cell damage under any condition. Both pumps performed to an acceptable level and appear safe to be used for red cell transfusion.

Quantitative assessment of haemolysis secondary to modern infusion pumps

“…In previous studies , potassium was much less sensitive than free haemoglobin, probably because of the smaller relative difference between the intracellular and extracellular levels of potassium vs. free haemoglobin in stored red blood cells. This could explain why potassium was not significantly increased by the pumps in our experiments.…”

“…Most of the infusion pumps previously tested with packed RBCs seemed to induce relatively low levels of haemolysis . However, there were some notable exceptions, including the pump that was previously used at our institution .…”

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

“…In eight studies (47.1%) there was a description of a lot of hemolysis when the erythrocytes were near to expiration 16 , 18 , 26 - 27 , 29 .…”

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

“…Little consensus exists regarding whether or not damage occurs when a particular method is used, and whether or not this is clinically relevant. Several published studies failed to demonstrate differences in hemoglobin concentration or osmotic fragility when comparing rotary and centrifugal pumps 7,8,10–12 . By contrast, linear peristaltic pumps have been found to increase the free hemoglobin concentration in other studies 11 .…”

“…A number of studies are available in the human literature that compare peristaltic pumps to centrifugal pumps or other methods of administration 5–9 . Most of these studies assess damage to red cells in vitro, and rarely examine the effect that transfusion administration has on in vivo red cell survival.…”