Neonatal Transfusion Practice: Hemolysis Markers After In Vitro Infusion of Packed Red Blood Cells by the Gravitational Method or Syringe Pump in a Peripheral Catheter

Abstract

The objective of this study was to verify the influence of the gravitational infusion method or syringe infusion pump on changes in hemolysis markers of irradiated and nonirradiated packed red blood cells (PRBCs) in vitro administered in a neonate peripheral intravenous catheter. An experimental study was conducted in a laboratory under controlled environmental conditions. Irradiated and nonirradiated PRBCs were administered in triplicate by the gravitational method and 10-mL/hour syringe infusion pump, in peripheral intravenous catheter, Vialon, 24-G caliber. Aliquots were collected directly from the PRBC bag, after manual filling of the infusion system and after infusion by the catheters. The following hemolytic markers were analyzed: degree of hemolysis (%), hematocrit (Ht, %), free hemoglobin (fHb, g/dL), potassium (K, mmol/L), and lactate dehydrogenase (LDH, U/L). Mann-Whitney and Student's t tests were used, P ≤ .05. The gravitational method significantly influenced increasing fHb (P = .007), Ht (P = .002), K (P = .002), and LDH (P = .003) values after PRBC irradiated infusion. The infusion of irradiated and non-irradiated PRBCs interferes with changes in hemolytic markers with the gravitational method. Syringe infusion pump proved to be a beneficial and safe alternative to irradiated and nonirradiated PRBC transfusion in newborns.