ABSTRACT
Objective
To investigate the effects of coincubation of various solutions and medications with canine packed red blood cells (pRBCs).
Design
Prospective in vitro study.
Experimental Units
Ten commercially prepared bags of canine pRBCs and fresh frozen plasma (FFP).
Interventions
pRBCs were coincubated with normal saline solution (NSS), 5% dextrose (D5W), Normosol-R, fentanyl, propofol, norepinephrine, dopamine, or same-donor FFP, as a control. Two pRBC storage times (<7 and 28–35 days) and two incubation times (3 and 30 min) were used.
Measurements and Main Results
CBC, light microscopy, methemoglobin assay, and osmotic fragility (OF) testing were performed to assess for hemolysis (decreased RBC count, decreased cellular hemoglobin), RBC swelling (increased mean cell volume [MCV], increased OF), and oxidant injury (increased methemoglobin, Heinz body formation). Results were analyzed by mixed-effect ANOVA to detect significant (p < 0.05) differences; results were also compared with the coefficient of variation of each test method to detect differences exceeding analytical imprecision. All results were compared with coincubation with same-donor FFP under the same conditions (storage and incubation times). NSS caused significant increases in MCV under all conditions. For >28-day-old blood, MCV was significantly increased with dextrose, norepinephrine, dopamine, and fentanyl. OF was mildly but significantly increased with SAL, norepinephrine, dopamine, and fentanyl. Coincubation with propofol resulted in many changes consistent with lipid emulsion artifact, impeding the detection of true additive effects.
Conclusions
Under the most ideal conditions tested (short coincubation of <7-day-old pRBCs), most additives had minimal deleterious effects on RBCs. However, NSS caused mild RBC swelling under all conditions. Mild RBC swelling and increased OF were also observed with most additives in older blood. The propofol lipid emulsion causes analytical interference that confounded the interpretation of results. Further investigation into the safety and efficacy of coadministration of RBCs with other products, including NSS, is indicated.
Journal of Veterinary Emergency and Critical Care, EarlyView.Wiley: Journal of Veterinary Emergency and Critical Care: Table of Contents