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Hemolysis biomarkers study of red blood cells infused by manual and eletronic infusion devices

Abstract

Transfusion of red blood cells is a widespread therapeutic intervention requiring however careful monitoring and indication, due to the possibility of adverse reactions and adverse events. The occurrence of non-immune hemolytic reaction during transfusion therapy has been achieving increasing concern and can be triggered by several causes, among them the mechanical trauma of the red blood cells resulting from the action of infusion devices. There are few and conflicting evidences to support the efficacy and safety of electronic and manuals infusion devices in the administration of packed red blood cells, due to the possible damages on erythrocytes induced by mechanical action of drippers and roller clamps of infusion sets, pressurizers and propulsion systems with positive pressure generated by infusion pumps, causing hemolysis levels capable of lead to deleterious consequences to the patient. This experimental study aims to determine the level of hemolysis of red blood cells administered by macro and micro drips infusion sets, infusion pumps with peristaltic and cassette mechanisms in different infusion rates, and an inflatable pressurizer system with pressure set at 300mmHg. Data collection and analysis will be performed in a laboratory of the Universidade Federal de São Paulo (Unifesp) and additional laboratory tests will be performed on the Associação Beneficente para Coleta de Sangue (COLSAN), after approval received by the Ethics Committee in Research, number 56518. The study samples will consist of packed red blood cells that would be designated for disposal and incineration, due to due to surplus stock and proximity of expiry of validity. Situations of nursing clinical practice will be simulated especially those performed in neonates and children undergoing transfusion therapy. Each fraction of red blood cells will be submitted to the electronic and manuals infusion devices and to control and experimental analysis of biomarkers of hemolysis: potassium, free hemoglobin, percentage of hemolysis, haptoglobin and lactate dehydrogenase. The variables will be analyzed according to the arithmetic mean, standard deviation and variance analysis, with significance level set at 0,05. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
PARDO, LARISSA PEREZ; KUSAHARA, DENISE MIYUKI; DE OLIVEIRA PIRES, MARIA PAULA; SILVA NANI, LUIZ AUGUSTO; MACHADO AVELAR, ARIANE FERREIRA; SORGINI PETERLINI, MARIA ANGELICA; GONCALVES PEDREIRA, MAVILDE LUZ. Effects of Blood Transfusion Sets on Red Blood Cell Hemolysis. JOURNAL OF INFUSION NURSING, v. 42, n. 6, p. 303-310, NOV-DEC 2019. Web of Science Citations: 0.
ANA MARIA MIRANDA MARTINS WILSON; MARIA ANGÉLICA SORGINI PETERLINI; MAVILDE DA LUZ GONÇALVES PEDREIRA. Hemolysis risk after packed red blood cells transfusion with infusion pumps. Revista Latino-Americana de Enfermagem, v. 26, p. -, 2018.
MIRANDA MARTINS WILSON, ANA MARIA; SORGINI PETERLINI, MARIA ANGELICA; GONCALVES PEDREIRA, MAVILDE DA LUZ. Infusion pumps and red blood cell damage in transfusion therapy: an integrative revision of the academic literature. Revista Latino-Americana de Enfermagem, v. 24, 2016. Web of Science Citations: 2.

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