Mechanical hemolysis in pediatric patients associated with rapid transfusion and one-way valve
| Autor: | Anthony Azakie, Martina Richtsfeld, Shelley Pulkrabek, Kayla R. Hansen, Thomas J. Gniadek, Nitasha Joyner, Nicole D. Zantek, Susan L. Barnett, Stephanie N Kinney, Claudia S. Cohn |
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| Rok vydání: | 2018 |
| Předmět: |
Syringe driver
Discolored urine medicine.diagnostic_test business.industry Immunology Acute kidney injury Hematology 030204 cardiovascular system & hematology Hematocrit medicine.disease Hemolysis 03 medical and health sciences Catheter 0302 clinical medicine 030202 anesthesiology Anesthesia medicine Free hemoglobin Immunology and Allergy business Syringe |
| Zdroj: | Transfusion. 58:1228-1233 |
| ISSN: | 0041-1132 |
| DOI: | 10.1111/trf.14554 |
| Popis: | BACKGROUND Four similar transfusion reactions involving infants were reported in less than 1 year. After transfusion of red blood cells (RBCs) via syringe in the operating room, each patient experienced discolored urine, laboratory evidence of hemolysis, and acute kidney injury. Clerical and serologic investigations were unremarkable. Mechanical hemolysis was considered. STUDY DESIGN AND METHODS Simulated syringe transfusions were performed. Measurements included hematocrit (Hct), free hemoglobin, and visual hemolysis index. Washed and unwashed RBCs were tested with or without a recently introduced one-way valve, using a 24- or 16-gauge intravenous catheter. Constant manual pressure (1.43 ± 0.49 mL/sec) or syringe pump (2 mL/min) was used and a subset was timed. RESULTS The valve increased hemolysis during manual transfusion using both catheters with washed and unwashed RBCs. With the 24-gauge catheter, the change in Hct was -3.53 ± 0.69% with the valve and 0.22 ± 0.13% without (p |
| Databáze: | OpenAIRE |
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