Abstract
Ethacrynic acid is a diuretic which has been recommended for intravenous administration in renal failure and for addition to packed red cells prior to transfusion in severe anemia. We have studied the effect of this drug on red blood cell lysis in vitro and have shown that hemolysis can occur with concentrations of ethacrynic acid of 1 mg/ml and increases with increasing drug concentration, temperature of incubation, and duration of exposure to the drug. With scanning electron microscopy, drug‐treated cells have undergone spheroechinocyte transformation. Autologous drug‐treated red blood cells in vivo have shown reduced 24‐hour posttransfusion survival and T½Cr with splenic sequestration after exposure of red cells for two hours to concentrations of ethacrynic acid which do not produce demonstrable lysis in vitro. Red cell survival in five out of six subjects taking oral ethacrynic acid 50 mg/bd was normal. It is suggested that the drug is contraindicated for addition to blood infusions and its use in high intravenous doses to children should, if possible, be avoided.
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