Hemólise em concentrados de glóbulos vermelhos administrados por meio de dispositivos de infusão de gotas e microgotas

• Ano de defesa: 2016
• Autor(a) principal: Pardo, Larissa Perez [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Hemolysis of packed; Red blood; gravity-driven infusion sets; Drops and microdrops; Hemólise em concentrados; Glóbulos vermelhos; Dispositivos de infusão; Gotas e microgotas
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=3794979; http://repositorio.unifesp.br/handle/11600/46954

The packed of red blood cells (RBC) is the most widely used blood components in clinical practice, with an infusion often accomplished by means of gravity-driven infusion devices of drops and microdrops. Despite the widespread use of these types of devices, little is known about its effect on quality of transfused blood component. Objectives: Verifying the levels of hemolysis markers, total hemoglobin, hematocrit, free hemoglobin, potassium, lactate dehydrogenase (LDH), haptoglobin and hemolysis degree before the RBC handling and following administration by the studied devices. Comparing RBC levels of hemolysis markers after infusion of drops and microdrops devices, according to device type, device brand, infusion rate and RBC storage time. Methods: An experimental study was conducted at Laboratory in Nursing Experiments (LEEnf) of the Federal University of Sao Paulo. 20 RBC units were used with an average of 16.08 (± 7.28) days of storage. They were studied in random order of 48 infusion devices of the drops type (24) and microdrops type (24), two different brands (A and B) and two infusion rates (10 and 100 ml/h) and three RBC storage time (short - up 10 days; medium - from 11 to 21 days and over - 21 to 35 days). The hemolysis markers were studied before the passage of blood through the infusion device known as Control and after the studied situation called Experiment. Samples obtained in the study were subjected to hematocrit analysis (%), total hemoglobin (g/dl), free hemoglobin (g/dl), , potassium (mmol/L), LDH (U/L), haptoglobin (g/L) and calculating the degree of hemolysis. Data were analyzed using mean and standard deviation, and applied the variance measurement tests, t student, ANOVA, Mann-Whitney, Levene, Kruskal-Wallis and Tukey (p?0.05). Results: We performed 576 analyzes of biomarkers and 96 percentage calculations of hemolysis. The overall assessment of the infused effect RBC showed significantly marginal decrease in total hemoglobin (p=0.062) and a significant increase of free hemoglobin level and the hemolysis degree (p<0.001). It is noteworthy that in the Experiment was identified maximum level of 0.9% hemolysis. It was identified hemolysis degree significantly higher (p=0.030) in the infusions made by microdrop infusion devices (26%), compared to the drops (15%). The devices brands did not influence significantly the hemolysis markers studied. The haptoglobin levels and LDH showed downward trend in the Experiment, and potassium levels and hematocrit also not statistically significant. The infusion rate of 10 ml/h resulted in greater variation in the degree of hemolysis (p=0.013), with relative increase of 22% after infusion, while 10% increase was observed at 100 ml/h. The storage time of RBC influenced the percentage of hematocrit (p<0.001) and level of LDH (p=0.004). Conclusion: Drip infusion devices of microdrops types caused a greater degree of hemolysis than the drops devices. The infusion rate of 10 ml/h was associated with a significant increase of hemolysis samples degrees. The devices brands and storage time did not influence the obtained results.