REDUCING BLOOD-DONOR EXPOSURES IN LOW-BIRTH-WEIGHT INFANTS BY THE USEOF OLDER, UNWASHED PACKED RED-BLOOD-CELLS

We performed a prospective, randomized masked trial to determine wheth er the use of dedicated units of packed red blood cells equipped with seven satellite bags would reduce donor exposures in infants with birt h weights <1500 gm. We also examined the use of unwashed and older red blood cells. Red blood cells given to the study group were used witho ut washing and until their expiration date (35 to 42 days). Changes in blood pH, potassium, ionized calcium, and hemoglobin were determined with each transfusion and compared with data collected from a control group that received washed, younger red blood cells. There was a 64% r eduction in donor exposures in the study group. Changes in infants' bl ood pH and calcium levels with transfusion were the same in the two gr oups, There was a clinically unimportant difference in potassium level s. A greater rise in hemoglobin values occurred when washed cells were used. There was no correlation between changes in the blood levels me asured and the age of unwashed cells infused. We conclude that the use of red blood cells from satellite bag-equipped dedicated units decrea ses donor exposures, and that the practices of using only younger red blood cells and of saline washing of red blood cells before infusion, are unwarranted.