Abstract：Objective: To study the effect of rapid infusion and observe the change of RBC morphologic,hemolysis rate and blood potassium during the different temperature and compression in order to provide a theoretical basis for the development of wartime rewarmed and pressurized transfusion devices. Methods: The 400ml whole blood stored at 4℃ for 10 days were slected. The pressurizing and rewarming devices were installed on the infusion stand before turning on the power and setting the repressurized parameters to 0Kpa,5Kpa,10Kpa,15Kpa and 20Kpa. The blood transfusion line was inserted into the rewarming tube of the heating instrument, and the thermostat was set up by adjusting the thermostat to set the heating temperature.A simulated rewarmed and pressurized infusion test was performed to detect the red blood cell morphology,the shape of the red blood cells and the blood transfusion effect after the blood flowed through the 40℃、45℃、50℃、55℃ heating tube under different pressure conditions. The variety in free hemoglobin concentration, serum potassium and blood flow rate were compared to evaluate the effect of infusion on blood quality and flow rate under different temperature and pressure conditions compared with untreated. Results: In a certain range for rewarming and pressurizing blood transfusion, the red blood cell hemolysis rate fluctuates at 0.035-0.093%, the measured value of plasma free hemoglobin varied between 0.075-0.184 g/L, and the blood potassium concentration fluctuates between 7.44mmol/L-9.75mmol/L. The test results showed no significant difference before and after infusion (P>0.05). With the increase of external temperature and pressure, a small amount of deformed red blood cells and cell debris could be seen under the high magnification when the temperature is higher than 55℃.The blood flow rate was positively correlated with the temperature and pressure intensity. Conclusion: The rewarmed and pressurized blood would not cause significant erythrocyte hemolysis in a short time under the temperature below 55℃ and pressure less than 20Kpa.The blood free hemoglobin and erythrocyte hemolysis rate had no significant change, with almost no effect on blood quality, but higher temperature and pressure were able to cause mild hemolysis of red blood cells and abnormal changes in morphology. The quality of blood was completely up to the standard requirements of the 2012 edition of the Management Regulations of Clinical Blood Transfusion in Medical Institutions.
马印图, 陈莉, 陈晓飞, 刘宏, 王哲, 谷建芳, 李莉华. 加温加压对输血效果及血液质量的影响[J]. 河北医学, 2021, 27(5): 859-863.
MA Yintu, et al. Study on the Effect of Rewarmed and Pressurized Blood Transfusion and Blood Quality. HeBei Med, 2021, 27(5): 859-863.
[1] Gonzales R,Taylor AL,Atkinson AJ,et al.US Army blood progrom:2025 and beyond[J].Transfusion,2016,56(Suppl 1):S85~S93. [2] Maciel JD,Gifford E,Plurad D,et al.The impact of a massive transfusion protocol on outcomes among patients with abdominal aoric injuries[J].Ann Vasc Surg,2015,29 (4): 764~769. [3] Poder TG,Pruneau D,Dorval J,et al. Effect of warming and flow rate conditions of blood warmers on red blood cell integrity[J].Vox Sang,2016,111( 4) : 341~349. [4] 朱红艳,孟强,欧阳红梅,等.流式细胞术检测红细胞渗透脆性试验方法的建立.中国实验血液学杂志[J].2016,24(1):229~232. [5] Wagner T,Pabst MA,Leitinger G,et al.Impact of constant storage temperatures and multiple warming cycles on the quality of stored red blood cells[J].Vox Sang,2014,106( 1) : 45~54. [6] Donati F,Acciarini R,De Benedittis I,et al. Detecting autologous blood transfusion in doping control: iomarkers of blood aging and storage measured by flow cytofluorimetry[J].Curr Pharm Biotechnol,2018,19( 2):124~135. [7] Balvers K,Wirtz MR,van Dieren S,et al.Risk factors for trauma-induced coagulopathy and transfusion-associated multiple organ in severely injured trauma patients [J].Front Med(Lausanne),2015,24(2):24~26. [8] Petel RM,Knezevvic A,Shenvi N,et al.Association of red blood cell transfusion,anemia and necrotizing enterocolitis in very low-birth-weight infants[J].JAMA,2016,315(9):889~897. [9] Barshtein G,Gural A,Manny N,et al.Storage-induced damage to red blood cell mechanical properties can be only partially reversed by rejuvenation[J].Transfusion medicine and hemotherapy,2014,41(3):197~204 [10] Simmonds MJ,Atac N,Baskurt OK,et al.Erythrocyte deform ability responses to intermittent and continuous subhemolytic shear stress[J].Biorheology,2014,51 (2-3):171~185. [11] 中华人民共和国卫生部,中国国家标准化管理委员会.GB18469-2012全血及成分血质量要求[M].北京:中国标准出版社,2012.
2021, Vol. 27 
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