Blood Components in the Treatment of Acute Blood Loss: Use of Freeze-Preserved Red Cells, Platelets, and Plasma Proteins.

摘要

To avoid untoward reactions from blood transfusions and to make best use of the limited supply of blood, anesthesiologists and surgeons have many newly developed means at their disposal. Blood components should be separated from whole blood at the time of collection and prepared for either liquid or freeze-preservation. Citrate-phosphate-dextrose (CPD) blood should be separated into its components at room temperature within 4 hours of collection for greatest service from each collected unit. Red cell concentrates with hematocrits of 70 volumes percent can be prepared from the whole blood at the time of collection and frozen either shortly thereafter or after storage at 4 C for up to 3 weeks. Redcell levels of 2.3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP) can be increased by a rejuvenation process prior to freeze-preservation with either 40% W/V glycerol and storage at -80 C or with 20% W/V glycerol and storage at -150 C. While hermorrhagic shock can best be managed with fresh whole blood, such blood is often not available; liquid- and freeze-preserved products serve as best substitutes.