Hemolysis of irradiated leukoreduced red blood cells during rapid warming: An in vitro experimental study
이수경, 이수호, 오종은, 신원정, 민원기, 곽미정,
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이수경 ( Lee Su-Kyung ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
이수호 ( Lee Soo-Ho ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
오종은 ( Oh Jong-Eun ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
신원정 ( Shin Won-Jung ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
민원기 ( Min Won-Ki ) - University of Ulsan College of Medicine Asan Medical Center Department of Laboratory Medicine
곽미정 ( Gwak Mi-Jeung ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
KMID : 0980320150150040229
Abstract
Background: Although water chambers are often used as surrogate blood-warming devices to facilitate rapid warming of red blood cells (RBCs), these cells may be damaged if overheated. Moreover, filtered and irradiated RBCs may be damaged during the warming process, resulting in excessive hemolysis and extracellular potassium release.
Methods: Using hand-held syringes, each unit of irradiated and leukocyte-filtered RBCs was rapidly passed through a water chamber set to different temperatures (baseline before blood warming, 50℃, 60℃, and 70℃). The resulting plasma potassium and free hemoglobin levels were then measured.
Results: Warming RBCs to 60℃ and 70℃ induced significant increases in free hemoglobin (median [interquartile ranges] = 60.5 mg/dl [34.9?101.4] and 570.2 mg/dl [115.6?2289.7], respectively). Potassium levels after warming to 70℃ (31.4 ± 7.6 mEq/L) were significantly higher compared with baseline (29.7 ± 7.1 mEq/L; P = 0.029). Potassium levels were significantly correlated with storage duration after warming to 50℃ and 60℃ (r = 0.450 and P = 0.001; r = 0.351 and P = 0.015, respectively).
Conclusions: Rapid warming of irradiated leukoreduced RBCs to 50℃ may not further increase the extracellular release of hemoglobin or potassium. However, irradiated leukoreduced RBCs that have been in storage for long periods of time and contain higher levels of potassium should be infused with caution.
키워드
Hemolysis; Hyperkalemia; Red blood cells; Transfusion
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