Stored Blood Research Articles

The stability of 65 biochemistry analytes in plasma, serum, and whole blood.

The pre-analytical stability of various biochemical analytes requires careful consideration, as it can lead to the release of erroneous laboratory results. There is currently significant variability in the literature regarding the pre-analytical stability of various analytes. The aim of this study was to determine the pre-analytical stability of 65 analytes in whole blood, serum and plasma using a standardized approach. Blood samples were collected from 30 healthy volunteers (10 volunteers per analyte) into five vacutainers; either SST, Li-heparin, K2-EDTA, or Na-fluoride/K-oxalate. Several conditions were tested, including delayed centrifugation with storage of whole blood at room temperature (RT) for 8 h, delayed centrifugation with storage of whole blood at RT or 4 °C for 24 h, and immediate centrifugation with storage of plasma or serum at RT for 24 h. Percent deviation (% PD) from baseline was calculated for each analyte and compared to the maximum permissible instability (MPI) derived from intra- and inter-individual biological variation. The majority of the analytes evaluated remained stable across all vacutainer types, temperatures, and timepoints tested. Glucose, potassium, and aspartate aminotransferase, among others, were significantly impacted by delayed centrifugation, having been found to be unstable in whole blood specimens stored at room temperature for 8 h. The data presented provides insight into the pre-analytical variables that impact the stability of routine biochemical analytes. This study may help to reduce the frequency of erroneous laboratory results released due to exceeded stability and reduce unnecessary repeat phlebotomy for analytes that remain stable despite delayed processing.

Caprine whole blood appears sufficiently stable after 21 days in storage to be suitable for transfusion.

The objective of this study was to determine hematologic changes of stored caprine whole blood in citrate phosphate dextrose adenine solution over a 28-day period. Ten 250-mL bags of whole blood were collected from 10 female Boer goats from Louisiana State University's Division of Laboratory Animal Medicine herd. 10 healthy blood donor goats were selected, and 250 mL of whole blood was drawn from each and stored at 2.78 °C. At the time of collection and every 7 days for a total of 28 days, samples were obtained from the blood bags to determine biochemical and hematologic values of collected blood. Only 5 of the 10 donors had baseline blood bag samples obtained for biochemical evaluation on day 0. At the end of 28 days, the remaining blood was submitted for aerobic and anaerobic culture. Blood values remained within suitable limits for transfusion and below 1% hemolysis for up to 21 days in most samples. Packed cell volume did not change significantly from day 0 to day 28. Lactate significantly increased over the 28 days, though not as dramatically as expected on the basis of other blood storage studies. pH decreased due to anticoagulant acidity but did not drop below 7. Cultures were negative on all blood bags. Changes over time are similar to that in other species, and caprine blood appears biochemically and hematologically stable for up to 21 days in storage. In vivo trials are needed for safety and efficacy.

Evaluation of Automated Magnetic Bead-Based DNA Extraction for Detection of Short Tandem Repeat Expansions With Nanopore Sequencing.

Long-read technologies such as nanopore sequencing provide new opportunities to detect short tandem repeat expansions. Therefore, a DNA extraction method is necessary that minimizes DNA fragmentation and hence allows the identification of large repeat expansions. In this study, an automated magnetic bead-based DNA extraction method and the required EDTA blood storage conditions as well as DNA and sequencing quality were evaluated for their suitability for repeat expansion detection with nanopore sequencing. DNA was extracted from EDTA blood, and subsequently, its concentration, purity, and integrity were assessed. DNA was then subjected to nanopore sequencing, and quality metrics of the obtained sequencing data were evaluated. DNA extracted from fresh EDTA blood as well as from cooled or frozen EDTA blood revealed high DNA integrity whereas storage at room temperature over 7 days had detrimental effects. After nanopore sequencing, the read length N50 values of approximately 9 kb were obtained, and based on adaptive sampling of samples with a known repeat expansion, repeat expansions up to 10 kb could be detected. The automated magnetic bead-based DNA extraction was sufficient to detect short tandem repeat expansions, omitting the need for high-molecular-weight DNA extraction methods. Therefore, DNA should be extracted either from fresh blood or from blood stored in cooled or frozen conditions. Consequently, this study may help other laboratories to evaluate their DNA extraction method regarding the suitability for detecting repeat expansions with nanopore sequencing.

Technological advancements, digital transformation, and future trends in blood transfusion services

Misidentification, mistransfusion, and pre-analytical errors are all regarded as major challenges and risks in safe blood transfusion procedures. To provide a high level of accuracy, traceability, automation, and reliability in blood transfusion services, traditional methods should be upgraded with modern technologies such as block chain technology, machine learning, artificial intelligence (AI), artificial neural networks, algorithm-based learning, and the implementation of radio frequency identification (RFID) and the internet of things (IoT). This technology helps reduce errors, retrieve data, forecast blood demand, reduce blood waste, manage blood storage, and manage workload, ensuring transfusion safety. The technology is still in the initial stages of development and by addressing issues such as data loss, patient data privacy, and cost-effectiveness, the technology will become a revolution in transfusion services.

The Difference In Potassium Levels In Fresh Blood Bags With Blood Bags Stored At Pku Muhammadiyah Gamping Hospital

Blood transfusion, one of them, is a process of transferring blood components containing glucose, lactate, and potassium. During storage, blood cells undergo metabolic changes such as decreased blood pH, hemolysis, and increased potassium levels. One of the complications of transfusion that must be avoided is hyperkalemia due to the release of potassium. This study aimed to determine differences in stored blood potassium levels and PRC QC results during 11 days of storage. This was an analytic observational study with a cross sectional approach. A T-test was used to analyze the difference. In addition, PRC blood quality control (QC) was also carried out for stored blood according to standards. This study used 40 samples of fresh blood bags obtained from UTD PMI Yogyakarta City. The mean potassium level in fresh blood bags was 4.373 ± 0.417 mmol/L (3.70-5.50) and the average potassium level in blood bags stored for 6 days was 8.290 ± 0.275 mmol/L (7.80-8.90). There was a significant difference in potassium levels between fresh blood bags and blood bags stored for 6 days (p = 0.000). The overall QC PRC result is 50% which indicates the need for improvement in terms of the blood component separation process.

Performance of far forward iceless blood storage containers in controlled cold environments.

The Golden Hour Box (GHB), an iceless blood container designed for transfusion closest to the point of injury, is used by military medical teams in remote damage control resuscitation. While its performance is well-established in hot environments, it remains underexplored in cold conditions, a significant consideration in emerging global conflict zones. Four GHBs were preconditioned at +4°C or +18°C for 8 h and subsequently exposed to controlled laboratory simulated temperatures of -5, -15, and -25°C for 100 h. The study focused on their capability to maintain an internal temperature between +2 and +6°C, the recommended range for red blood cells unit storage and transport, using calibrated sensors for precise monitoring. When exposed to negative Celsius temperatures, GHBs showed varied performance depending on preconditioning temperatures. When preconditioned at +4°C, GHBs maintained an internal temperature within the target range (+2 to +6°C) for 100 h at -5°C, 52 ± 1 h at -15°C, and 29 ± 4 h at -25°C. In contrast, the internal temperature of GHBs preconditioned at +18°C exceeded this range in less than 30 min, then dropped below 2°C more rapidly than those preconditioned at +4°C, occurring within 20 ± 2 h at -15 and 13 ± 1 h at -25°C. The GHB, when properly preconditioned, effectively maintains internal temperatures suitable for blood product transport in extreme cold. Future research, including analyses of blood performances, is still needed to validate these results in more realistic operational conditions for use in cold environments.

Optofluidic-based deformability cytometry: Characterizing erythrocyte elasticity and assessing storage quality

Erythrocyte elasticity is an inherent, label-free marker for both physiological and pathological changes in erythrocytes, serving as a criterion for assessing the quality and suitability of stored blood. Although varieties of cell elasticity measurement techniques have been proposed, a small sample, non-contact, and continuous method is still in need. This article introduces an optofluidic-based deformability cytometry (O-DC) for characterizing erythrocyte elasticity, combining non-contact optical force with microfluidic technology. A tightly focused laser beam optically traps an erythrocyte, and the flow force induces cell deformation, allowing for elasticity characterization through force-dependent elongation. The O-DC technique offers high accuracy and desirable throughput for cell elasticity characterization, facilitated by quasi-static stretching and continuous cell delivery. The characterization throughput of O-DC is ∼3 cells per second at a flow rate of 30 μL/h and a laser power of 200 mW. Fresh erythrocytes exhibit measured elastic strains of 15.4–27.8% across flow rates of 10–30 μL/h, with an estimated elastic modulus of 2.6±0.3 μN/m. Using O-DC, the elasticity trend of erythrocytes stored for 0–6 weeks was analyzed, with their average elastic modulus increasing from 2.6±0.3 μN/m to 6.1±0.8 μN/m as the storage time increased. Our study highlights the potential of O-DC in clinical diagnostics and biomechanical research applications.

Post-mortem formation of ethanol: Is 1-propanol a reliable marker? A proof-of-concept study using an invitro putrefactive environment setup.

Ethanol is the psychoactive substance identified most frequently in post-mortem specimens. Unfortunately, interpreting post-mortem ethanol concentrations can be difficult because of post-mortem alcohol redistribution and the possibility of post-mortem alcohol neogenesis. Indeed, in the time interval between death and sample collection, the decedent may be exposed to non-controlled environments for an extended period, promoting microbial colonization. Many authors report that in the presence of carbohydrates and other biomolecules, various species of bacteria, yeast, and fungi can synthesize ethanol and other volatile substances invitro and invivo. The aim of this study was to study the impact of several variables on microbial ethanol production as well as develop a mathematical model that could estimate the microbial-produced ethanol in correlation with the most significant consensual produced higher alcohol, 1-propanol. An experimental setup was developed using human blood samples and cadaveric fragments incubated under strictly anaerobic conditions to produce a novel substrate, "cadaveric putrefactive blood" mimicking post-mortem corpse conditions. The samples were analyzed daily for ethanol and 1-propanol using an HS-GC-FID validated method. The formation of ethanol was evaluated considering different parameters such as putrefactive stage, blood glucose concentration, storage temperature, and storage time. Statistical analysis was performed using the Mann-Whitney non-parametric test and simple linear regression. The results indicate that the early putrefactive stage, high blood glucose concentration, high temperature, and time of incubation increase microbial ethanol production. In addition, the developed mathematical equation confirms the feasibility of using 1-propanol as a marker of post-mortem ethanol production.

Strategies to Obtain and Deliver Blood Products Into Critically Injured Children: A Survey of Pediatric Trauma Society Members.

Timely transfusion is associated with improved survival and a reduction in in-hospital morbidity. The benefits of early hemorrhagic shock recognition may be limited by barriers to accessing blood products and their timely administration. We examined how pediatric trauma programs obtain blood products, the types of rapid infusion models used, and the metrics tracked to improve transfusion process efficiency in their emergency department (ED). We developed and distributed a self-report survey to members of the Pediatric Trauma Society. The survey consisted of 6 initial questions, including the respondent's role and institution, whether a blood storage refrigerator was present in their ED, the rapid infuser model used to transfuse critically injured children in their ED, if their program tracked 4 transfusion process metrics, and if a video recording system was present in the trauma bay. Based on these responses, additional questions were prompted with an option for a free-text response. We received 137 responses from 77 institutions. Most pediatric trauma programs have a blood storage refrigerator in the ED (n = 46, 59.7%) and use a Belmont rapid infuser to transfuse critically injured children (n = 45, 58.4%). The American College of Surgeons Level 1 designated trauma programs, or state-based equivalents, and "pediatric" trauma programs were more likely to have video recording systems for performance improvement review compared with lower designated trauma programs and "combined pediatric and adult" trauma programs, respectively. Strategies to improve the timely acquisition and infusion of blood products to critically injured children are underreported. This study examined the current practices that pediatric trauma programs use to transfuse critically injured children and may provide a resource for trauma programs to cite for transfusion-related quality improvement.

Plasma p-tau181 as an outcome and predictor of multidomain intervention effects: a secondary analysis of a randomised, controlled, dementia prevention trial.

It is unknown whether multidomain interventions, which might preserve late-life cognition, affect Alzheimer's disease pathology. Previous studies measured cerebrospinal fluid and imaging Alzheimer's disease biomarkers in small subsamples of multidomain trial participants. Newly developed assays enable the measurement of blood-based Alzheimer's disease biomarkers in larger samples. We aimed to assess whether plasma tau phosphorylated at threonine 181 (p-tau181) was able to detect or predict 3-year multidomain intervention effects. This is a secondary analysis of the randomised, controlled, Multidomain Alzheimer Prevention Trial (MAPT) testing a 3-year multidomain intervention, omega-3 fatty acid supplementation, or both versus placebo, in individuals aged 70 years and older in 13 memory centres in France and Monaco. Plasma p-tau181 was measured in stored blood samples in a subsample of 527 participants on an intention-to-treat basis. Changes in cognitive score were calculated as a composite measure using the average of Z scores for the following tests: Mini Mental State Examination orientation items, Free and Cued Selective Reminding Test (sum of free and total recall scores), category fluency, and Digit Symbol Substitution Test. Intervention effects on 3-year change in p-tau181 concentration were estimated by use of a linear mixed model with centre-specific random intercepts. Recruitment took place between May 30, 2008, and Feb 24, 2011. Median baseline plasma p-tau181 was 8·8 pg/mL (IQR 6·7-11·9) in the total sample, and significantly higher in older individuals, men, APOE ε4 carriers, and participants with renal dysfunction or a positive PET amyloid scan. During 3-year follow-up, individuals with raised baseline p-tau181 underwent greater cognitive decline (eg, mean difference in 3-year change on the composite cognitive score between control group participants with normal and abnormal baseline levels of p-tau was -0·34 [effect size -0·52; 95% CI -0·61 to 0·07] in the fully adjusted model using a 12·4 pg/mL cutoff for abnormal baseline p-tau181), but there were no intervention effects on change in p-tau181 either in this subgroup or the total population, and no effect on cognitive change in individuals with raised baseline p-tau181 (eg, in the fully adjusted model using the 12·4 pg/mL cutoff for p-tau181 abnormality, the mean difference [95% CI] in this subgroup in 3-year decline on the composite cognitive score between the control group and the multidomain + omega-3 group, the omega-3 group, and the multidomain intervention group, was, respectively: 0·13 [-0·21 to 0·47], 0·03 [-0·30 to 0·36], and 0·10 [-0·26 to 0·46]). Surprisingly, individuals with raised baseline p-tau181 showed a decrease in p-tau181 during follow-up (eg, unadjusted mean [95% CI] 3-year change was -3·01 pg/mL (-4·45 to -1·56) in control group subjects with abnormal baseline p-tau181 [using the 12·4 pg/mL abnormal p-tau cutoff]). Our results support the utility of p-tau181 as a prognostic biomarker, but it did not predict or detect intervention effects in this study. Further investigation of its usefulness as a prevention trial outcome measure is required. Toulouse Gérontopôle, French Ministry of Health and Pierre Fabre Research Institute.

The effect of whole blood logistics on neutrophil non-specific activation and kinetics ex vivo

While the exquisite sensitivity of neutrophils enables their rapid response to infection in vivo; this same sensitivity complicates the ex vivo study of neutrophils. Handling of neutrophils ex vivo is fraught with unwanted heterogeneity and alterations that can diminish the reproducibility of assays and limit what biological conclusions can be drawn. There is a need to better understand the influence of ex vivo procedures on neutrophil behavior to guide improved protocols for ex vivo neutrophil assessment to improve inter/intra-experimental variability. Here, we investigate how whole blood logistics (i.e., the procedure taken from whole blood collection to delivery of the samples to analytical labs and storage before neutrophil interrogation) affects neutrophil non-specific activation (i.e., baseline apoptosis and NETosis) and kinetics (i.e., activation over time). All the experiments (60+ whole blood neutrophil isolations across 36 blood donors) are performed by a single operator with optimized isolation and culture conditions, and automated image analysis, which together increase rigor and consistency. Our results reveal: (i) Short-term storage (< 8 h) of whole blood does not significantly affect neutrophil kinetics in subsequent two-dimensional (2D) cell culture; (ii) Neutrophils from long-term storage (> 24 h) in whole blood show significantly higher stability (i.e., less non-specific activation) compared to the control group with the isolated cells in 2D culture. (iii) Neutrophils have greater non-specific activation and accelerated kinetic profiles when stored in whole blood beyond 48 h.

Direct Analysis of Whole Blood by a Disposable Monolithic Column Mass Spectrometry Analysis Kit†

Comprehensive SummaryA monolithic column‐based mass spectrometry (MS) analysis kit was prepared for whole blood analysis with MS. The kit is disposable and can be used for purification, storage, transportation and direct analysis of whole blood. The kit mainly consists of a capillary for quantitative microsampling, a cation exchange monolithic column for purification and storage, and a syringe for loading sample. This kit is very friendly to various users that one can easily siphon the blood in the kit followed by rapid clean‐up. We established a quantitative method using the kit with a limit detection as low as 0.33 nmol/L, and achieved more than five orders of magnitude enhancement in sensitivity compared to direct nanoelectrospray ionization MS analysis. The column can avoid analyte exposure to environment, which helps the storage of the sample for laboratory analysis. The relative standard deviation of immediate blood analysis and storage blood analysis within 10 d was less than 10%. This method has been successfully applied to the quantitative analysis of procainamide hydrochloride in 2 μL rat blood. These results indicate that this disposable kit does have the potential to achieve highly sensitive quantitative MS analysis in biological samples, which is expected to become a cost‐effective and powerful tool for in vitro diagnostics.

Improvement of heating and cooling performance for thermoelectric devices in medical storage application

Thermoelectric devices provide several advantages over typical refrigeration systems, including compact size, quiet operation, minimal energy use, and environmentally friendly. By harnessing these benefits, we have developed a blood storage system that has the potential to transform the way blood products are preserved and safeguarded. Thermal performance was evaluated using a variety of scenarios, including thermal fin material and emissivity, voltage operation, heat sink type (I, U, O type), and tube load. This research used thermoelectric devices, Styrofoam materials, thermal fin and the heatsink to design the thermoelectric storage cabinet with heat insulation function. The aims to improve the performance of thermoelectric devices by optimizing the thermal fin design during heating/cooling storage mechanisms. Our findings emphasize the importance of thermal radiation, particularly in circumstances with low natural convection and high surface emissivity. Thermal performance is optimized when heating storage elements are incorporated into aluminum finned tubes and run at an input voltage of 8V in a 25 °C ambient temperature. In addition, using U-shaped cooling fins in cooling conditions results in superior cooling performance. The outcomes of this study highlight the possibility and potential benefits of using thermoelectric devices to heat and cool medical storage, notably blood storage applications. The insights gained here contribute to advancing the efficiency and sustainability of medical storage systems, ultimately benefiting healthcare and the environment.

An Assessment of the Viability of Haematological and Haemostatic Parameters of Blood under certain Storage Conditions at the Rivers State University Teaching Hospital Blood Bank in Port Harcourt, Nigeria

Introduction: Despite significant advances in transfusion medicine, concerns about the inherent risks of blood transfusion persist, even under optimal temperature and duration of storage. This makes the evaluation of blood viability a global task (1). Maintenance of adequate temperature is considered a key factor in the viability and quality of stored blood in healthcare institutions. Evaluating the haematological and haemostatic functionality of blood elements at different storage temperature and duration is therefore imperative for improving patient care and resource utilization in Rivers State University Teaching Hospital (RSUTH) blood bank in Port Harcourt.&#x0D; Methods: In this cohort study design, a total of sixteen (16) male and female blood donors in equal proportion of sex and ABO blood groups were randomly selected from the Port Harcourt blood donors' population and recruited as study subjects for this research. A well-structured questionnaire and the immunoassays were used to assess the donors' health and serological status respectively. Also the sample obtained were analayzed by automation and data statistically analyzed using ANOVA.&#x0D; Results: The results of this study shows a statistically significant decrease in white blood cell count from 4.93×109/L ± 0.33 to 2.79×109/L ± 1.68 (p=0.00) and platelet count from 227.38×109/L ± 32.17 to 153.75×109/L ± 58.39 (p=0.00) at day 7. Also, a significant decrease in platelet count from 227.38×109/L ± 32.17 to 141.50±60.92 at day 14. A significant decrease in Fibrinogen from 340.75mg/L±18.69 to 281.2575 mg/L ±46.41 at day 1 and day 14 respectively, and rise in PT and aPTT from 17.02s ±1.28 to 24.31s ±6.67 and 41.25s±3.23 to 46.63s±6.28 at day 14th to day 21 respectively (p=0.00).&#x0D; Conclusion and Implications for Translation: Pooled plasma at 4-60C contain clinically significant amount of coagulation factors up to day 21 in storage. The WBC and platelet is lost within seven day of storage at 4-60C. Lower temperatures, especially freezing at -60°C accelerate the loss of haematological viability of blood especially the depletion of white blood cells and platelets (p=0.00). Antihaemophilic factor and fibrinogen is maintained in FFP at 180 day in storage at -600C.

Blood Component Usage and Discard in the Blood Centre of a Tertiary Care Hospital in a Remote Part of North-east India: A Cross-sectional Study

Introduction: Blood and its various components are valuable resources for sustaining life. They are routinely used and form an integral part of patient care. The judicious use of blood and its components is necessary in low socio-economic countries. Aim: To estimate the usage of blood and blood components and its discard in a tertiary care hospital. Materials and Methods: A hospital-based retrospective cross- sectional study was conducted in the Blood Centre, Diphu Medical College and Hospital, Karbi Anglong, Assam, India. Data was retrieved from Blood Centre registers over a period of 12 month, from July 2021 to June 2022. Both replacement and voluntary donors were selected based on donor selection criteria. All collected blood units were stored and subsequently subjected to Transfusion Transmitted Infections (TTI) testing. The data was tabulated using Microsoft Excel sheet. Results: During the study period, a total of 4,525 units of whole blood were collected, and 7,539 blood units, including both whole blood and blood components, were prepared. The highest number of issues during the period comprised of whole blood at 2,468 units. Among blood components, 1,854 units of Packed Red Blood Cells (PRBCs) were most commonly utilised, followed by 1,824 units of Fresh Frozen Plasma (FFP). A total of 334 units (4.43%) of blood/ blood components were discarded due to various reasons, with the highest discard rate observed for Platelet Concentrates (PC) at 71 (6.28%) units. The major reason for discard was seropositivity, accounting for 212 (63.5%) units. Conclusion: Adequate blood inventory, along with proper training and sensitisation of hospital staff, should be conducted at timely intervals regarding proper donor selection, collection, and storage of blood/ blood products. Clinicians should also be engaged to optimise the usage of blood/ blood products. These steps can help minimise wastage in resource limited countries.

Impact of cold storage on the oxygenation and oxidation reactions of red blood cells.

Introduction: Electrostatic binding of deoxyhemoglobin (Hb) to cytoplasmic domain of band 3 anion transport protein occurs as part of the glycolytic regulation in red blood cells (RBCs). Hb oxidation intermediates not only impact RBC's oxygenation but also RBC's membrane through the interaction with band 3. It is not known however whether these critical pathways undergo changes during the storage of RBCs. Methods and Results: Oxygen parameters of fresh blood showed a sigmoidal and cooperative oxygen dissociation curve (ODC) for the first week of storage. This was followed by a large drop in oxygen affinity (P50) (from 30 to 20mmHg) which remained nearly unchanged with a slight elevation in Bohr coefficients and a significant drop in extracellular acidification rates (ECAR) at the 42-day storage. Oxidation of Hb increased with time as well as the formation of a highly reactive ferryl Hb under oxidative stress conditions. Ferryl Hb interacted avidly with RBC's membrane's band 3, but to lesser extent with old ghost RBCs. Discussion: The observed alterations in RBC's oxygen binding may have been affected by the alterations in band 3's integrity which are largely driven by the internal iron oxidation of Hb. Restoring oxygen homeostasis in stored blood may require therapeutic interventions that target changes in Hb oxidation and membrane changes.

Bacterial contaminants in stored blood and blood products at Zomba Central Hospital Blood Bank: assessing the possible risk of post-transfusion sepsis in a resource-limited setting

Bacterial contaminants in stored blood and blood products at Zomba Central Hospital Blood Bank: assessing the possible risk of post-transfusion sepsis in a resource-limited setting

Growth and Distribution of Bacteria in Contaminated Whole Blood and Derived Blood Components

Introduction: Bacterial contamination of blood products presumably occurs mainly during blood collection, starting from low initial concentrations of 10–100 colony-forming units (CFUs) per bag. As little is known about bacterial growth behavior and distribution in stored whole blood (WB) and WB-derived blood products, this study aims to provide data on this subject. Methods: WB units were inoculated with transfusion-relevant bacterial species (Acinetobacter baumannii, Bacillus cereus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Pseudomonas fluorescens, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus dysgalactiae, Streptococcus pyogenes, Yersinia enterocolitica; n = 12 for each species), stored for 22–24 h at room temperature, and then centrifuged for separation into plasma, red blood cells (RBCs), and buffy coats (BCs). The latter were pooled with 3 random donor BCs and one unit of PAS-E each to yield plasma-reduced platelet concentrates (PCs). Samples for bacterial colony counting were collected after WB storage and immediately after blood component production. Sterility testing in PCs (n = 12 for each species) was performed by bacterial culture after 7 days of storage. Results: Bacterial growth in WB varied remarkably between donations and species. Streptococcus species produced the highest titers in WB, whereas Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas fluorescens did not multiply. Centrifugation resulted in preferential accumulation of bacteria in BCs, with titers of up to 3.5 × 103 CFU/mL in BCs and up to ≤0.9 × 103 CFU/mL in BC-derived PCs. Overall, 72/144 PCs (50%) tested positive for bacteria after storage. Sterility test results were species-dependent, ranging from 12 of 12 PCs tested positive for Streptococcus pyogenes to 1 of 12 PCs positive for Escherichia coli. Bacterial contamination of RBC and plasma units was much less common and was associated with higher initial bacterial counts in the parent WB units. Conclusions: Bacterial growth in WB is species-dependent and varies greatly between donations. Preferential accumulation of bacteria in BCs during manufacturing is a critical determinant of the contamination risk of BC-derived pooled PCs.

Electrochemical analysis of antioxidant status of biological media in different sampling and storage conditions

The use of an electrochemical approach for assessment of the oxid-ative stress severity is a promising direction for point-of-care testing develop-ment, which is especially important for critically ill patients. The aim of this study was to determine the influence of different types of blood collection tubes (with clot activator and separating gel, lithium heparin, sodium citrate and K2EDTA) and storage conditions (at 25, 4 and ?23 ?C up to 5 days) on the electrochemical analysis of the antioxidant status of blood plasma, assessed by measuring the open circuit potential of platinum electrode (OCP) and antioxid-ant capacity via cyclic voltammetry method (q). It was obtained that blood col-lection tubes with lithium heparin and clot activator are the most suitable for the electrochemical analysis of antioxidant status of blood plasma, since they do not affect the results of measurements. Furthermore, data obtained during storage blood plasma samples in different temperature conditions indicate that it is preferable to perform electrochemical analysis in fresh samples.

Development and Implementation of a Standard Operating Procedure for Military Working Dog Blood Collection, Storage, and Transport.

Military working canines are critical assets and force multipliers for the Joint Force. Most often deployed forward of Role 2 assets, they are reliant on non-veterinary resources when wounded, ill, or injured in an operational environment. Hemorrhagic shock is the most prevalent form of shock seen in battlefield injuries and is most effectively treated with whole blood transfusion. Dogs cannot be transfused with human blood and there is no formal Department of Defense (DoD) canine blood product distribution system to operational settings. A walking blood bank is helpful when multiple dogs are geographically co-located and the resource can be provided to an injured patient quickly. In areas as widely dispersed as the Horn of Africa, the likelihood of co-location is slim and delaying this vital resource can mean the difference between life and death. Therefore, personnel at the Role 2 facility in Camp Lemonnier, Djibouti, filled a critical capability gap for the operational area by producing a local canine whole blood bank with distribution to multiple countries. This protocol can be replicated by other locations to improve medical readiness for the working canines who serve to maintain DoD Force Protection.