Five-day storage of platelets in a non-diethylhexyl phthalate- plasticized container

A non-diethylhexyl phthalate (DEHP)-plasticized blood bag for 5-day storage of random-donor platelet concentrates has been developed. The plastic bag is composed of polyvinylchloride plastic with a butyryl trihexyl citrate plasticizer. The suitability of this plastic for the storage of platelet concentrates for use in clinical transfusion practice was evaluated. In vitro storage studies showed no significant differences at Day 5 for a series of in vitro assays (test plastic vs. control plastic) including pH (7.31 vs. 7.44), lactate dehydrogenase discharge (21.8 vs. 17.1%), pO2 (103 vs. 120 torr), osmotic recovery (52 vs. 57%), and morphology score (527 vs. 516). For paired radiolabeled recovery and survival data from autologous blood donors, results showed equivalence between the test plastic and two control plastics. A small but significant difference between test and control plastics in regard to survival was found by using a linear computer model, but not with a gamma function (multiple-hit) model. For paired transfusions to thrombocytopenic patients, the corrected count increments at 1 to 4 hours (test vs. control) were 13,534 versus 15,494 (p > 0.05, NS). Similar results were seen for corrected count increments determined at 12 to 24 hours. It can be concluded that platelets stored in the test plastic are acceptable for use in clinical practice.     

Storage of saline-adenine-glucose-mannitol-suspended red cells in a new plastic container: polyvinylchloride plasticized with butyryl-n- trihexyl-citrate

Blood collection and component preparation have been performed in integrally connected multiple plastic containers made with a new plastic. This polyvinylchloride (PVC) container plasticized with butyryl-n-trihexyl-citrate (BTHC) is a new material for blood storage; it contains no di(2-ethylhexyl)phthalate (DEHP). After removal of plasma and buffy coat, the red cells were suspended in saline-adenine-glucose-mannitol (SAGM) medium. After 42-day refrigerator storage, the total adenine nucleotide concentration remained the same as the initial concentration in the red cells, whereas ATP levels had decreased to 61 percent of the initial value. The 2,3 DPG concentration was 62 percent of normal on Day 7 and 21 percent on Day 14. Glucose consumption, lactate production, potassium leakage from red cells, and pH levels were similar to those found after storage in DEHP-plasticized containers under the same conditions. After 42 days, hemolysis levels were 0.56 +/- 0.21 percent and 0.42 +/- 0.17 percent in two series of units mixed weekly and 0.70 +/- 0.27 percent in units stored unmixed. Although even higher levels of hemolysis were observed in the units stored unmixed and used for 24-hour posttransfusion survival, the autologous red cell recovery results were excellent (83.2 +/- 5.1%, n = 8). BTHC-plasticized PVC is found to be a suitable material for 42-day storage of red cells in SAGM solution.     

Freezing in the primary polyvinylchloride plastic collection bag: a new system for preparing and freezing nonrejuvenated and rejuvenated red blood cells

Red blood cells were stored at 4 C in the primary bag with an integrally attached empty transfer pack so that the red blood cells could be rejuvenated or not, as desired before glycerolization and freezing. The rejuvenation and glycerol solutions were added through ports in the system. After glycerolization, the red blood cells were concentrated by centrifugation to remove the supernatant glycerol before freezing with 40% w/v glycerol in the primary polyvinylchloride (PVC) plastic container at −80 C. After thawing, the red blood cells were washed using either the Haemonetics Blood Processor 115 or the IBM Blood Processor 2991-1 or 2991-2. In each system, 50 ml of 12% sodium chloride and 1.5 to 1.6 liters of 0.9% sodium chloride-0.2% glucose-25 meq/l disodium phosphate were used. Recovery of red blood cells in vitro was 91 per cent. After three days of postwash storage at 4 C, nonrejuvenated red blood cells had a mean 24-hour posttransfusion survival of 88 per cent, and outdated-rejuvenated red blood cells a value of 81 per cent. This new system is simpler and safer than methods previously used in this laboratory, and red blood cell recovery and 24- hour posttransfusion survivals were comparable or better.     

A new, rapid, one-step method for the isolation of platelets from human blood

We describe a new, rapid method for the isolation of platelets from human blood using a single centrifugation step through Nycodenz, an inert, nontoxic, nonionic medium. As judged by aggregation and nucleotide release studies, the platelets are recovered in high yield and in excellent functional condition.     

胆道外引流储存袋的设计及应用

目的探讨自行设计的胆道外引流储存袋的临床应用效果。方法选取介入科2017年7月—12月收治的32例恶性梗阻性黄疸的患者为试验组;2017年1月—6月收治的33例恶性梗阻性黄疸的患者为对照组。试验组采用自行设计的胆道外引流储存袋携带引流袋,对照组采用传统的手提方法或S钩、别针外挂引流袋。观察两组导管引流不畅、脱管、逆行感染的发生情况,以及两组患者满意度。结果试验组未发生引流不畅;对照组有3例(9.1%)发生引流不畅。试验组未发生逆行感染及脱管;对照组有2例(6.1%)发生逆行感染,2例(6.1%)发生脱管。试验组和对照组对携带引流管活动时的患者满意度评分分别为10～15(12.82±2.12)分和6～12(9.06±1.92)分。结论胆道外引流储存袋使用方便、安全,可提高患者的满意度。     

气囊导尿管新用途

气囊导尿管除用于导尿、膀胱冲洗、膀胱造漏外，临床上还广泛用于灌肠、胸腔闭式引流、肠癌及鼻出血的治疗、膀胱灌注、脓肿引流等。     

气囊导尿管新用途

气囊导尿管除用于导尿、膀胱冲洗、膀胱造漏外,临床上还广泛用于灌肠、胸腔闭式引流、肠瘘及鼻出血的治疗、膀胱灌注、脓肿引流等。     

新式单鼻塞吸氧装置固定存放袋

单鼻塞吸氧装置在基层医院使用普遍,但反复吸氧、间断吸氧过程中氧管的存放固定一直困扰着护理人员。以往按照操作规范用纱布包裹吸氧管,但包裹后氧管头端容易滑落。针对这种现象,我们设计了单鼻塞吸氧装置固定存放袋。现介绍如下。     

Evaluation of a new, more oxygen-permeable, polyvinylchloride container

A new container made of polyvinylchloride (PVC) with diethylhexyl phthalate (DEHP) used as the plasticizer was subjected to in vitro and in vivo evaluation for prolonged platelet storage. As compared with the original PVC bag, this bag has increased gas permeability by its reduced film thickness, larger surface area (400 ml capacity), and more porous label. The oxygen permeability coefficient, K(O2), of the new container was measured to be 655 nmol per min per atm. On the basis of previous studies relating the K(O2) to the maximal platelet count, it was predicted that this maximal count would be in the range of 7.9 to 8.9 X 10(10) platelets. This prediction was confirmed by carrying out 58 studies measuring pH, pO2, and platelet count on platelet concentrates (PCs) stored for up to 7 days. After 5 days of storage all PCs with counts above 8.0 x 10(10) had pH less than or equal to 7.0, whereas those with counts below 8.0 x 10(10) had pH greater than or equal to 7.0. Six units (10%) with counts above 9.0 X 10(10) had pH levels of 6.5 or below. Thirteen of the PCs underwent extensive in vitro testing of platelet function during 7 days of storage. No significant differences were found in pH, ATP content, and decrease in platelet count, as compared with studies (n = 22) using PCs stored in polyolefin containers.(ABSTRACT TRUNCATED AT 250 WORDS)     

Storage of platelets on flatbed agitators in polyvinyl chloride blood bags plasticized with tri(2-ethylhexyl) trimellitate

Data are presented showing that platelets in polyvinyl chloride blood bags plasticized with tri(2-ethylhexyl) trimellitate can be stored on flatbed agitators (shakers) without the pH falling below 6.0. The lowest pH seen after 7 days of storage in 46 units with platelet yields ranging from 3.6 to 13.3 X 10(10) per unit was 6.43. These bags have a O2 transmission rate of 13.3 mumol per hour per bag. Platelet bags with a O2 transmission rate of 7.9 mumol per hour per bag experience a pH fall after 5 days of storage on the shaker in units whose platelet yield on average exceeds 10 X 10(10). Platelets can be stored on first-generation shakers (70 cycles/min, stroke = 1 inch) without an attempt at manual resuspension of the platelet button. The count after 30 minutes on the shaker averaged 89 +/- 15 percent of the expected count, indicating that resuspension was nearly complete after a relatively short period. Red cells, but not platelets, settled out during storage on the shaker.     

5-day storage of platelets collected on a blood cell separator

One of the earliest devices available for plateletpheresis is the Haemonetics system; this machine has been updated recently to permit the use of software in a closed system and thus storage of the collected platelets beyond 24 hours. The authors examined the in vitro and in vivo function of platelets collected on the Haemonetics AutoSurge machine and stored for 5 days in two separate 1000-mL CLX bags. The average count per bag was 1.8 +/- 0.4 x 10(11) in approximately 200 mL of plasma. Immediately following collection, the platelet response to ADP and epinephrine represented 78 and 35 percent, respectively, of the preapheresis values. Aggregation to single stimuli subsequently decreased to 29 and 0 percent, respectively by Day 5. This response is equal to or better than the response reported with the Fenwal CS-3000, the only other plateletpheresis device routinely used for long-term storage. The pH of the preparations was well maintained throughout storage, and there was little alteration in hypotonic shock response or serotonin uptake. Serotonin release decreased consistently. The morphology scores indicated good maintenance of shape immediately following collection; this subsequently decreased after 5 days of storage. Bacterial cultures were negative in all instances. The 51Cr in vivo survival and recovery was good with 65.5 +/- 7.1 percent recovery and an average survival of 7.3 +/- 1.3 days (multiple hit; n = 5). The data indicate that storage of the Haemonetics plateletpheresis product is feasible and that the product is as good as others currently available.     

Buffy coat platelets stored in apyrase, aprotinin, and ascorbic acid in a suspended bag: combined strategies for reducing platelet activation during storage

BACKGROUND: Platelet activation is an important factor impeding the clinical effectiveness of platelet transfusions. In this study, platelet concentrates (PCs) were prepared by a novel suspended-bag buffy coat technique that was followed by the addition of a mixture of platelet activation inhibitors to the storage bag. STUDY DESIGN AND METHODS: In vitro platelet function was evaluated in PCs prepared by the suspended-bag buffy coat technique and stored at 22 degrees C for 5 days in the presence of (n = 12) or absence (n = 12) of apyrase, ascorbic acid, and aprotinin (AAA). RESULTS: Platelets from AAA- incubated PCs demonstrated mean ATP levels 17 percent (p < 0.004), 13 percent (p < 0.02), and 22 percent (p < 0.003) higher than those measured in parallel control PCs on Days 1, 3, and 5, respectively. Similarly, on Days 3 and 5 of storage, respectively, 45-percent (p < 0.001) and 50-percent (p < 0.001) greater ADP-induced maximum aggregation was observed in AAA-incubated PCs than was seen in control preparations. AAA-incubated PCs demonstrated alpha-granule membrane protein-140 expression 92 percent (p < 0.01), 133 percent (p < 0.003), and 104 percent (p < 0.001) below that in control PCs on Days 1, 3, and 5, respectively. At similar intervals, a significant increase in recovery from hypotonic shock also was observed in AAA-incubated PCs. Further, Day 5 AAA-PCs demonstrated significantly higher morphology scores and O2 consumption than did control preparations. CONCLUSION: Buffy coat platelets prepared in suspended bags and stored in the presence of AAA demonstrate significantly reduced activation and enhanced functional and metabolic activity.     

Defining the optimal storage conditions for the long-term storage of platelets

Aging of platelets after in vitro storage at 22 degrees C is significantly slower than aging of platelets in vivo at 37 degrees C, a situation that may make long-term storage of platelets possible. Three approaches appear to be of specific importance: (1) to reduce the activation of platelets during collection of blood and the preparation and storage of platelet concentrates, (2) to reduce the metabolic rate of glucose consumption and lactate production, and (3) to make sure that glucose is available in the storage medium during the entire storage period. The activation of platelets can be counteracted either by the addition of platelet activation inhibitors or the availability of certain components such as potassium and magnesium in the synthetic storage media. The use of synthetic media offers the possibility to include additional platelet-specific components in the storage environment. A number of effects have been observed that can be assigned to certain added components. Reducing platelet activation and the inclusion of key components in the platelet storage environment, such as glucose, acetate, citrate, phosphate, potassium, and magnesium, may optimize storage conditions for the long-term storage of platelets.     

Collection of platelets with a new cell separator and their storage in a citrate-plasticized container

A new apheresis device using microprocessor control for the collection of a high-purity single-donor platelet concentrate was evaluated, as was the storage of platelets for up to 5 days in a citrate-plasticized polyvinylchloride blood bag. The study was conducted in three phases: collection of platelets for in vitro studies and determination of donor safety; autologous transfusion of platelets in healthy volunteers; and transfusion of platelets in patients requiring platelet transfusion therapy. Donors had mild hypocalcemia and minimal changes in blood counts except for a platelet count reduction from 288 +/- 50 x 10(3) (288 +/- 50 x 10(9)/L) to 217 +/- 43 x 10(3) per microL (217 +/- 43 x 10(9)/L). A mean of 3.36 +/- 1.24 x 10(11) platelets was collected in the mean volume of 214 mL with red cell and white cell contamination in the range of 10(7). Morphology and aggregation were as described previously in stored platelets. Platelet survival data in eight subjects showed a mean recovery of 61 +/- 11 percent and mean survival of 5.03 +/- 1.07 days by a weighted-mean model. Patients transfused with platelets had mean increments of 23,000 immediately and of 8000 at 24 hours; corrected count increments were 6000 at 1 hour and 4000 at 24 hours. The platelets were successful in providing hemostasis to these patients. Clinically useful 5-day-stored platelets are obtained by using this apheresis technology with a functionally closed system and a citrate-plasticized blood bag.