On behalf of: Milkins Clare (RWG) West Hertfordshire TR [[log in to unmask]]
The BCSH Guideline on the Administration of Blood Components (2009) does
not advocate the simultaneous co-administration of red cells with
Lactated ringers solutions.
These guidelines, available at
http://www.bcshguidelines.com/documents/Admin_blood_components_bcsh_0501
2010.pdf, state:
Compatible Intravenous Fluids
- It is generally advised that no other intravenous fluids should be
co-administered via an infusion line that is being used for a blood
component (when multi-lumen central venous access devices are used it is
generally safe to co-administer other therapeutic solutions through a
different lumen as rapid dilution occurs in the bloodstream).
- Intravenous solutions which contain calcium, such as Ringer Lactate,
and calcium-containing colloids, such as Haemaccel(tm) or Gelofusine(tm)
may antagonise citrate anticoagulant and allow clots to form in the
blood component.
- Hypotonic intravenous solutions, such as 5% dextrose in water, may
cause haemolysis of red cells. The relevance of this in clinical
practice is uncertain as the in vitro studies reported in the literature
involved prolonged exposure of red cells to dextrose solutions at room
temperature. Although a slight degree of visible haemolysis has been
observed in the intravenous tubing when 5% dextrose is infused following
red cell transfusion, no clinical adverse events have been reported
(Klein and Anstee 2005).
- The practice of priming or flushing administration sets used for the
transfusion of blood components with isotonic (0.9%) saline is not
evidence based and, we believe, unnecessary. No other intravenous fluids
should be used for this purpose. If used, local policies or guidelines
should determine how saline used to prime/flush administration sets
should be prescribed/documented.
Best wishes
Clare
Clare Milkins
Scheme Manager
UK NEQAS (BTLP)
+44 (0) 1923 217933
-----Original Message-----
From: Clinical biochemistry discussion list
[[log in to unmask]] On Behalf Of
[log in to unmask] [[log in to unmask]]
Sent: 21 March 2013 14:48
To: [log in to unmask]
Subject: Blood Banking question
Please send to your transfusion service/blood banking colleagues
What is your institution's stance (and that of UK) on the
co-administration (simultaneously) of red blood cell units with Lactated
ringers (or Hartman solution)
It is prohibited in the US by American Association of Blood Bank
standards and the FDA.
Dr. Alter
David Alter, MD DABCC
Clinical/Chemical Pathologist
Blood Bank Medical Director
Spectrum Health Regional Laboratory
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