Effects of various arterial infusion solutions on red blood cells in the newborn
Jodi K Jackson, Douglas P Derleth
Department of
Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA
Correspondence to: Dr Derleth, Mayo Clinic Ei-S22, Rochester, MN 55905, USA email: derleth.douglas{at}mayo.edu
Accepted 27 March 2000
AIM
To examine in
vitro the effects of brief contact with various infusion solutions on
red blood cells from newborn infants, as occurs in the "waste"
syringe during routine blood sampling from umbilical artery catheters.
The mixture of blood and solution in the "waste" syringe is usually
reinfused into the baby. Reinfused red blood cells may be damaged by
the infusion solution. It is hypothesised that an isotonic amino acid
solution would cause no red blood cell agglutination and no more
haemolysis than many commonly used solutions.
METHODSBlood was
obtained from the placentas of 15 normal term babies. Haemolysis was
estimated by measuring plasma (free) haemoglobin after mock blood
sampling. Agglutination was measured semiquantitatively by direct observation.
RESULTSA 0.25%
normal saline solution caused 5.4% haemolysis, significantly more than
all the other fluids tested. There was less haemolysis with 0.25%
normal saline when there was complete mixing of blood and solution
within the "waste" syringe. Normal saline and isotonic sodium
acetate solutions caused < 0.1% haemolysis, significantly less than
all the other fluids tested. The isotonic amino acid solution caused
0.8% haemolysis, which is similar to that caused by the remaining
solutions tested. Agglutination was seen with isotonic dextrose and
with the two isotonic amino acid solutions containing cysteine.
CONCLUSIONSIsotonic
amino acid solution (without added cysteine) caused no agglutination
and the same or less haemolysis than many commonly used solutions and
may offer advantages in nutrition and fluid balance.
Keywords: haemolysis; agglutination; umbilical artery catheter; infusion solutions; amino acids; nutrition
© 2000 by Archives of Disease in Childhood
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This article has been cited by other articles:
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Jackson, J. K., Biondo, D. J., Jones, J. M., Moor, P. J., Simon, S. D., Hall, R. T., Kilbride, H. W.
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