Shall red cell units stand upright, lie flat or be mixed during storage? In vitro studies of red cells collected in 0.5 CPD and stored in RAS2 (Erythrosol).

Red cells were prepared using a new anticoagulant with half the normal amount of citrate and a new additive solution (RAS2, Erythrosol) previously shown to give improved storage conditions, and stored in a highly gas permeable plastic container (PL 2209). Mixing daily and weekly resulted in lower PCO2, higher PO2 and more rapid oxygen saturation of the haemoglobin than storage unmixed in an upright position. Storage horizontally in a lying position unmixed resulted in similar blood gas values as with mixing. The haemolysis was lowest in units mixed once weekly: 0.21 +/- 0.09% after 28 days and 0.26 +/- 0.06% after 56 days. The morphology was better maintained in mixed than in unmixed units. Horizontal storage and mixing once per week seem to be optimal as judged from these in vitro studies.

Half-strength citrate CPD combined with a new additive solution for improved storage of red blood cells suitable for clinical use.

Currently used systems for red blood cell (RBC) collection and storage for transfusion have the disadvantage that the RBC 2,3-bisphosphoglycerate (BPG) concentration is depleted within two weeks of storage, resulting in a left-shift of the oxygen dissociation curve and a temporarily impaired capacity to deliver oxygen. We have studied the effects on red cell metabolism, morphology and in vivo recovery of 49-day storage of RBC, with collection in half-strength citrate CPD (0.5CPD) and storage in an additive solution containing citrate, adenine, mannitol, phosphate and glucose (RAS2). Traditional CPD-SAGM was used for comparison. Component preparation was performed after an initial holding period of the whole blood at ambient temperature for 8 h. The BPG concentration in 0.5CPD-RAS2 RBC was 0.633 +/- 0.120 mol (mol Hb)-1 as compared to 0.454 +/- 0.138 mol (mol Hb)-1 in CPD-SAGM RBC which implied a decrease to 67 and 48% of normal concentration, respectively. The mean RBC BPG concentration was maintained at the initial level for 28 days in the new system but decreased to very low levels within 14 days in the controls. The total adenine nucleotides were well maintained in both systems, adenosine triphosphate slightly better in the new system. Hemolysis after 49 days was 0.35 +/- 0.21% in the new system and 0.72 +/- 0.25% in the controls (p < 0.001). The morphology was better maintained in the new system (p < 0.001). The 24-hour posttransfusion survival of 49-day stored RBC was 78.9 +/- 7.1%. The membrane leakage of sodium and potassium was not significantly different in the two systems.(ABSTRACT TRUNCATED AT 250 WORDS)