023 – Stored blood versus fresh salvaged blood

Hi Everyone,

Congratulations & kudos Jeremy Hickey who correctly identified that this blood gas was a sample from a unit of stored allogeneic blood, sorry we don't have any actual prize except for getting a mention on the podcast and the glory of seeing your name in print on the website! (If we have any more quizzes we may have to look into this.) Ryan Juniper also deserves a mention for his post on the facebook page which was also very close.

What is the storage lesion of blood? What is 2,3 DPG? What happens to red cell deformability?

Join Graeme and I for a 15minute discussion around the changes that occur in allogeneic blood when it is stored and why this may affect both it's function and the undesirable effects this may have on our patients. We also briefly discuss and try to make a case for why salvaging and re-infusing a patients own fresh blood may be a much better option if you can achieve this during surgery - however we will leave a detailed discussion on cell salvage for another episode.

Last weeks blood gas - taken from 23 day old stored allogeneic red cells

References
Click on these to link to the pubmed article:

1.  Osman N. Salaria, MD, Viachaslau M. Barodka. Impaired Red Blood Cell Deformability After Transfusion of Stored Allogeneic Blood but not Autologous Salvaged Blood in Cardiac Surgery Patients. Anesth Analg. 2014 Jun; 118(6): 1179–1187.

2. Andrew V. Scott, BS, Enika Nagababu. 2,3-Diphosphoglycerate Concentrations in Autologous Salvaged Versus Stored Red Blood Cells and in Surgical Patients After Transfusion. Anesth Analg. 2016 Mar; 122(3): 616–623.

3. Xiu Liang Li,1 Peng Dong. Oxygen carrying capacity of salvaged blood in patients undergoing off-pump coronary artery bypass grafting surgery: a prospective observational study. J Cardiothorac Surg. 2015; 10: 126.

4. National Blood Authority video - blood still saving lives but there are risks.