Assessing the Compatibility of Packed Red Blood Cells with Lactated Ringers Solution
Abstract
Crystalloid solutions are frequently used to reconstitute packed red cells during rapid infusions during trauma situations and in the perioperative setting. Lactated Ringers solution is a commonly used crystalloid for intravenous infusion. Calcium contained in lactated Ringers solution has been reported to possibly cause blood clots because of replacing calcium ions previously chelated in the citrate anticoagulant. Authors of previous studies have cautioned against using lactated Ringers solution to reconstitute packed red cells because of this calcium. Other studies have shown that there are no adverse effects when lactated Ringers is used in situations when packed red cells are transfused rapidly. In this study, samples of CPD-preserved red cells were diluted with either lactated Ringers solution or normal saline. The aliquots were diluted to ratios between 10:1 and 1:10 (packed red cells to crystalloid) and incubated at room temperature and 37 degrees centigrade and then examined for clot formation at intervals up to two hours. Clotting occurred at dilutions of 1:1 and higher, and no clots formed in clinically relevant dilutions between 5:1 and 2:1. Additional units of CPD-preserved blood were diluted to hematocrit values of 35, 45, 55 and 65 percent and were passed through blood tubing to simulate an actual transfusion. Flow rates of packed red cells diluted with lactated Ringers solution and normal saline were compared. There was no measurable difference in the flow rates.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 1998
- Accession Number
- AD1011837
Entities
People
- Edward J. Helpling
Organizations
- Uniformed Services University of the Health Sciences