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1.
Transfusion ; 39(9): 998-1004, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10533827

ABSTRACT

BACKGROUND: In recent years, there has been a change from the use of blood stored in CPDA-1 to the use of red cells (RBCs) stored in electrolyte mixtures, such as Adsol (AS-1 RBCs). However, because Adsol contains mannitol, as well as increased amounts of glucose relative to CPD and CPDA-1, concerns have been expressed as to possible harmful effects (recipient hyperglycemia, inappropriate osmotic diuresis) that it might induce under conditions of massive RBC transfusion. STUDY DESIGN AND METHODS: A hemorrhagic shock animal model was used to evaluate the effects of large-volume infusion of CPDA-1 or Adsol on glucose homeostasis and on urinary output under conditions that were devoid of extensive surgical manipulation. Hemorrhage was induced in 10 female Pitman-Moore mini-pigs to maintain mean arterial blood pressure at 55 mmHg for 90 minutes. After the return of autologous RBCs plus 1 L of 0.9-percent sodium chloride, the animals were given solution equivalent to the solute load in either 20 units of CPDA-1 whole blood (63 mL x 20 = 1260 mL) or 20 units of AS-1 RBCs (100 mL x 20 = 2000 mL) over a period of 90 minutes. Animals were monitored to determine physiologic and blood chemical responses to infusion of the solutions and to determine if there was hyperglycemia or inappropriate diuresis in the Adsol-treated group. RESULTS: Animals that received CPDA-1 developed significant hypocalcemia, arterial hypotension, and elevated blood glucose concentrations; two of five animals died of circulatory collapse. In contrast, glucose metabolism in the Adsol recipients was well-regulated, serum ionized calcium concentration was not significantly altered, and all animals survived. No evidence of inappropriate diuresis was observed. CONCLUSION: Administration of large amounts of Adsol was not associated with hyperglycemia or inappropriate osmotic duiresis in hemorrhaged and resuscitated minipigs. These data suggest that fewer physiologic changes may be associated with the massive transfusion of AS-1 RBCs than with that of CPDA-1 whole blood.


Subject(s)
Adenine/pharmacology , Blood Preservation , Citrates/pharmacology , Glucose/pharmacology , Hemorrhage/veterinary , Mannitol/pharmacology , Phosphates/pharmacology , Sodium Chloride/pharmacology , Swine Diseases/prevention & control , Animals , Blood Glucose/analysis , Blood Transfusion/veterinary , Disease Models, Animal , Electrolytes/blood , Female , Hemorrhage/prevention & control , Hemorrhage/rehabilitation , Hypotension/therapy , Resuscitation/methods , Solutions/pharmacology , Swine , Swine, Miniature
3.
J Parenter Sci Technol ; 45(5): 212-7, 1991.
Article in English | MEDLINE | ID: mdl-1753310

ABSTRACT

It is common hospital pharmacy practice to preload syringes with selected drugs and store them ready for use. Because the several components of syringes, (such as barrels, gasket seals, etc.) may vary among manufacturers, there exists the possibility that syringe components of differing provenance might interact e.g., by sorption, with stored drugs to differing degrees. To examine possible interactions, three brands of commercially available syringes were compared to determine what influence, if any, short term storage of injectable solutions might exert on the solutions or the syringes. Four drugs; dexamethasone sodium phosphate, diazepam, diatrizoate meglumine and nitroglycerin USP were individually loaded into 3 mL syringes and stored at temperatures between -20 degrees C and + 25 degrees C for periods from 6 hours to 30 days. The syringes were examined for any gross changes. Drug solutions were analyzed after storage to determine the presence of organic leachates from the syringes and any change from original drug concentration values. No syringes showed gross physical changes after storage with drug solution nor were any drug solutions found to contain leachates on gas chromatographic-mass spectroscopic analysis. Drug concentrations were seen to change following storage, the greatest changes occurring with the highly lipophilic drugs dexamethasone and diazepam. In most instances loss of drug concentration was most rapid at room temperature. Although there were clear differences among the three brands of syringe, no overall pattern emerged which might allow the selection or rejection of one syringe over another for the extemporaneous preloading of the drugs examined.


Subject(s)
Drug Stability , Materials Testing , Pharmacy Service, Hospital/methods , Plastics , Syringes , Drug Storage/methods , Gas Chromatography-Mass Spectrometry , Temperature , United States
4.
Blood ; 72(2): 766-9, 1988 Aug.
Article in English | MEDLINE | ID: mdl-3401597

ABSTRACT

Platelets gradually lose their disc shape during storage. The authors studied simultaneous changes in platelet cytosolic Ca2+ (Cai) and the polymerization state of actin as related to the shape. Platelet concentrates were stored under blood bank conditions for up to 10 days. Aliquots were removed and analyzed as follows: platelet Cai and increments in Cai induced by adenosine diphosphate (ADP) were determined by fluorescence of fura-2-loaded cells; loss of disc shape was determined by differences in light scattering intensity induced by stirring; and the ratio of globular and total actin (G/T) of platelets in plasma was determined by a modification of the DNase inhibition assay. Globular actin was found to be 86 +/- 3% of total actin in freshly drawn platelets suspended in plasma. The following changes occurred during storage: G/T in platelet concentrates increased from 63 +/- 5 (day 0) to 74 +/- 2% in the first 24 hours then fell to 33 +/- 6% by day 10. The percent discoid platelets also increased from day 0 to day 1 then fell in the ensuing days. There was an initial drop in Cai from day 0 to day 1, after which Cai increased on days 3 and 6. Globular actin polymerization during storage closely correlated with the change in percent discs (r = 0.95). During 6 days of storage Cai was highly correlated with shape change (r = 0.97) and to a lesser extent (r = 0.87) with the ratio of globular actin. The authors conclude that actin polymerization, shape, and Ca2+ change in a related fashion during storage.


Subject(s)
Actins/metabolism , Blood Platelets/metabolism , Blood Preservation , Calcium/analysis , Blood Platelets/physiology , Cytosol/analysis , Humans , Polymers/metabolism
7.
Transfusion ; 17(1): 71-3, 1977.
Article in English | MEDLINE | ID: mdl-841679

ABSTRACT

Accumulation of phthalate plasticizer (di-(2-ethylhexyl) phthalate, DEHP) was markedly reduced in blood stored as packed cells rather than as whole blood. After the first week, the accumulation rate in whole blood was essentially linear, but in packed cells DEHP accumulation was lower, and reached a plateau. At three weeks whole blood contained about three times more DEHP than did packed cells. Smaller amounts of plasma and restricted diffusion probably limited DEHP accumulation in packed cell preparations.


Subject(s)
Adenine/pharmacology , Blood Preservation/methods , Diethylhexyl Phthalate/blood , Phthalic Acids/blood , Humans , Polyvinyl Chloride , Time Factors
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