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Research Article| Volume 20, ISSUE 1, P29-36, February 1999

Nutricel as an additive solution for neonatal transfusion

  • G Rock
    Correspondence
    Corresponding author. Address. Chief, Division of Hematology, Ottawa Hospital – Civic Campus, 1053 Carling Avenue, Ottawa, Ontario, Canada K1Y 4E9 Tel.: +001 613 761 4254; fax: +001 613 761 4847.
    Affiliations
    Department of Laboratory Medicine, Ottawa Hospital – Civic Campus and Hospital for Sick Children, Toronto, Canada K1Y 4E9
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  • A Poon
    Affiliations
    Department of Laboratory Medicine, Ottawa Hospital – Civic Campus and Hospital for Sick Children, Toronto, Canada K1Y 4E9
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  • S Haddad
    Affiliations
    Department of Laboratory Medicine, Ottawa Hospital – Civic Campus and Hospital for Sick Children, Toronto, Canada K1Y 4E9
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  • R Romans
    Affiliations
    Department of Laboratory Medicine, Ottawa Hospital – Civic Campus and Hospital for Sick Children, Toronto, Canada K1Y 4E9
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  • P.St Louis
    Affiliations
    Department of Laboratory Medicine, Ottawa Hospital – Civic Campus and Hospital for Sick Children, Toronto, Canada K1Y 4E9
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      Abstract

      Red cell concentrates stored in additive solutions have limitations for use in the pediatric population. Our survey of 10 pediatric institutions found that Nutricel supernatant was often removed prior to infusion. Examination of packed red cells showed a potassium concentration in excess of 15 mmol/l by day 7 in AS-3 and 40 mmol/l by day 35. Comparison with cells stored in CP2D and CPDA1 showed that the total mass of potassium was highest in AS-3 (5.6 mmol/l) as was the phosphate. The total mass of citrate and glucose was considerably increased in the AS-3 system at 1.73 mmoles and 3.23 mmoles. All had a pH less than 6.6 at day 35. The high concentration of potassium in AS-3 raises concern for the potential for hyperkalemic dysrhythmias during massive transfusion while the citrate load has clinical implications for divalent cation homeostasis during rapid infusion or exchange; the glucose may induce hyperglycemic sequelae.
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