Hemolysis risk after packed red blood cells transfusion with infusion pumps.
Ana Maria Miranda Martins Wilson, Maria Angélica Sorgini Peterlini, Mavilde da Luz Gonçalves Pedreira
PMID 30328976WHAT IT FOUND
In lab tests, the degree of hemolysis did not rise through infusion pumps, but potassium increased, especially at the faster rate.
No patient outcomes were measured.
Key findings
01The degree of hemolysis did not change significantly across the three phases, regardless of pump or infusion rate.
02Potassium increased after infusion, with a significant rise at 300 mL/h.
03At 300 mL/h, the maximum degree of hemolysis was 0.81% with pump A and 0.83% with pump B, but the 0.83% value was from the bag sample.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a laboratory test on blood units, not a clinical study, so it cannot show whether transfusion through these pumps harmed patients. Only four packed red blood cell units were used, and the authors did not design direct comparisons between the two pumps. Storage time varied from 19 to 30 days, and temperature and exposure time varied during the experiments, which can affect potassium and hemolysis markers. The 0.83% hemolysis value above the 0.8% limit was already present in the bag sample before infusion. Potassium and free hemoglobin were not routinely assessed in blood banks, and reference values for them were not established.
Declared interests
The supplied text reports support from FAPESP, Brazil, grant #2012/25284-9, and does not list author conflicts of interest.
The easy way to misread this
Do not conclude that rapid infusion pump transfusion damages patients' red cells. This was a laboratory test on four blood units, the degree of hemolysis did not change significantly, and the 0.83% value above the 0.8% limit was already present in the bag. The pumps also used different accessories, so the effect of any one device cannot be separated.