Description:
<jats:sec><jats:title>Background</jats:title><jats:p>Transfusion guidelines advise against coinfusing red blood cells (<jats:styled-content style="fixed-case">RBC</jats:styled-content>s) with solutions other than 0.9% saline. We evaluated the impact of coinfusion with dextrose‐containing fluids (<jats:styled-content style="fixed-case">DW</jats:styled-content>) on markers of <jats:styled-content style="fixed-case">RBC</jats:styled-content> quality.</jats:p></jats:sec><jats:sec><jats:title>Study Design and Methods</jats:title><jats:p>A pool‐and‐split design was used to allow conditions to be tested on each pool within 2 hours of irradiation. Three pools at each storage age (5, 14, and 21 days) were created for each phase. In Phase 1, samples were infused through a neonatal transfusion apparatus alone or with treatment solutions: <jats:styled-content style="fixed-case">D</jats:styled-content>5<jats:styled-content style="fixed-case">W</jats:styled-content>, <jats:styled-content style="fixed-case">D</jats:styled-content>10<jats:styled-content style="fixed-case">W</jats:styled-content>, <jats:styled-content style="fixed-case">D</jats:styled-content>5<jats:styled-content style="fixed-case">W</jats:styled-content>/0.2% saline, and 0.9% saline. In Phase 2, samples were incubated alone or in a 1:1 ratio with treatment solutions and tested after 5, 30, and 180 minutes. Hemolysis, supernatant potassium, <jats:styled-content style="fixed-case">RBC</jats:styled-content> indices, morphology, and deformability were measured on all samples.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In Phase 1, <jats:styled-content style="fixed-case">RBC</jats:styled-content>s transfused alone through the apparatus had higher (p < 0.01) hematocrit, total hemoglobin, and supernatant potassium compared to all other groups. No statistical differences were identified between groups for other measured variables. In Phase 2, mean corpuscular volume of all samples containing <jats:styled-content style="fixed-case">DW</jats:styled-content> increased with incubation length and were higher (p < 0.01) than <jats:styled-content style="fixed-case">RBC</jats:styled-content>s incubated alone or with 0.9% saline after 30 and 180 minutes. <jats:styled-content style="fixed-case">RBC</jats:styled-content>s incubated with <jats:styled-content style="fixed-case">D</jats:styled-content>5<jats:styled-content style="fixed-case">W</jats:styled-content> and <jats:styled-content style="fixed-case">D</jats:styled-content>5<jats:styled-content style="fixed-case">W</jats:styled-content>/0.2% saline had greater (p < 0.05) hemolysis than <jats:styled-content style="fixed-case">RBC</jats:styled-content>s alone after 180 minutes.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In vitro characteristics of <jats:styled-content style="fixed-case">RBC</jats:styled-content>s coinfused with 0.9% saline or <jats:styled-content style="fixed-case">D</jats:styled-content>10<jats:styled-content style="fixed-case">W</jats:styled-content> were not adversely impacted. When developing clinical studies in neonates, we recommend use of <jats:styled-content style="fixed-case">D</jats:styled-content>10<jats:styled-content style="fixed-case">W</jats:styled-content> and a transfusion apparatus that minimizes the contact volume of the coinfusate with the <jats:styled-content style="fixed-case">RBC</jats:styled-content>.</jats:p></jats:sec>