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Expediting red blood cell transfusions by syringing causes significant hemolysis

De Villiers, Willem Lambertus (2017-12)

De Villiers, W.L., Murray, A.A. & Levin, A.I. 2017. Expediting red blood cell transfusions by syringing causes significant hemolysis. Transfusion, 57(11):2747-2751.

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INTRODUCTION: During resuscitation, medical personnel frequently need to expedite red blood cell concentrate (RBC) transfusions. RBC infusion rates are typically accelerated by increasing the diameter of, or pressure gradient over, the intravenous cannula. Increasing the proximal pressure is typically achieved by applying external pressure to the RBC bag. Alternatively, RBC contents may be aspirated into a syringe, which is then used to forcefully inject the blood into the patient. The latter may sometimes be the only option, for example when re-infusing cell saver blood where pressurizing the bag carries the risk of air embolism. In recent years at our hospital, manual syringing has been widely adopted even for expediting transfusions. Little is known about the effects of syringing or pressurization on red cell lysis.1,2 We decided to compare the effects of these techniques on RBC hemolysis using a simulated expedited transfusion model.

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