| Ringer's lactate is compatible with saline-adenine-glucose-mannitol preserved packed red blood cells for rapid transfusion. | |
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MedLine Citation:
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PMID: 20922586 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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PURPOSE: Guidelines state that Ringer's lactate (RL) should not be co-administered with packed red blood cells (PRBC) due to a potential risk of clotting. The purpose of this study was to determine whether RL causes clotting in PRBC with the currently used preservative, saline-adenine-glucose-mannitol (SAGM). METHODS: Phase 1: Samples from 12 units of SAGM-PRBC were diluted from 0-97.5% with RL and normal saline (NS), incubated for 30 min, and passed through 40 μm filters. Additional samples were frozen and batch analyzed using an enzyme-linked immunosorbent assay (ELISA) to measure prothrombin activation fragment 1 + 2 (F1 + 2), indicative of thrombin generation. Packed red blood cells were also diluted, flushed with crystalloid using a rapid transfusion model, and filtered. Phase 2: Eight further units were serially diluted with RL and incubated for 30, 60, 120, 180, and 240 min. Fresh samples were analyzed by filtration and ELISA. RESULTS: Phase 1: No clotting was seen during filtration or using the transfusion model with NS or RL. The F1 + 2 ranged from 2.28 to 154.37 pmol·L⁻¹ in NS dilutions and from 2.80 to 1675.93 pmol·L⁻¹ in RL dilutions, indicating coagulation in some samples. Phase 2: No clotting was observed within 60 min by filtration or ELISA. However, 4 of the 8 units showed clots in the filters of some dilutions between 120 and 240 min. CONCLUSIONS: No clotting was detected at any dilution of RL with SAGM- preserved PRBC within 60 min, but clotting was detected with extended incubation. The results indicate RL can be safely co-administered with PRBC during rapid transfusion (< 60 min). |
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Authors:
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Brendan Levac; Joel L Parlow; Janet van Vlymen; Paula James; Angie Tuttle; Lois Shepherd |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-05 |
Journal Detail:
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Title: Canadian journal of anaesthesia = Journal canadien d'anesthésie Volume: 57 ISSN: 1496-8975 ISO Abbreviation: Can J Anaesth Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8701709 Medline TA: Can J Anaesth Country: United States |
Other Details:
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Languages: eng Pagination: 1071-7 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston General Hospital, ON, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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