1. In order to discide the method by which the platelet count in the circulating blood might be measured as accurately as possible, both Olef's and Fonio's methods were investigated. Glass and polymethyl methacrylate plates were used in both methods. Olef's method with glass plate was proved to be the best of the four methods, since it was accompanied by the least error, great convenience and comparatively good protective action on the platelets.2. The change of the platelets following the transfusion of 200cc of the compatible blood was investigated by measuring the platelet count prior to, and 30min., 1 hour, 2 hours and 24 hours after the transfusion in 30 patients. The red blood cell showed little change in number and the change of the white blood cell count was not consistent. The platelet count in the circulating blood, on the hand, revealed a marked change.A. Change of the platelet counta) Transfusion of ACD containing, preserved blood in 10 cases;The peak of the change came one hour following the transfusion, and ranged from 24 to 56 percent decrease in 8 cases, and from 20 to 57 percent increase in 2 cases.b) Transfusion of sodium citrate containing, fresh blood in 10 cases;Decreased in 8 cases and increased in 2 cases. The changes and their recovery in this group occurred earlier than in a).The rate of the change in this group was about the same as in a).c) Transfusion of heparin containing, fresh blood in 10 cases;Decreased in 6 cases and increased in 4 cases. The rate of change, especially the increase rate, was more marked than in a) and b).B. Incidence of complicationsThe most frequent of all complications associated with blood transfusion was urticaria.In sodium citrate group of twenty patients, there was mild urticaria in 4 cases and pruritus in 1 case, i. e. 25% out of 20 patients.There was thrombocytopenia in all patients with complications. No correlation between the severity of thrombocytopenia and the symptomatology of complications was detected.In the heparin containing fresh blood group of 10 patients, there were 4 cases of urticaria (severe in one and mild in three) and 1 pruritus out of 6 thrombocytopenic patients, and 2 (moderate in one associated with coughs and severe in another associated with fever) out of 2 thrombocytotic patients. The thrombocytosis of the last 2 patients was as marked as up to 75 and 73 percent in increase.3. In another group of 30 patients who were administered 20cc of intravenous MgSO4 solution 30min. prior to the transfusion of 200cc ACD preserved blood, the changes of the platelet count and complications following the transfusion were investigated. MgSO4 was administered in 10% in water in 10 cases and 10% in 5% glucose solution in 20 cases.The variation of the r. b. c. count was the same as the one encountered in 5 cases (17%) out of 30 patients in this group and, on the other hand, 15 cases (75%) out of a control or sodium citrate group of 20 patients. The difference above mentioned was statistically significant with less than 0.1% of significance level.As to the complications, there were two cases of urticax is (6.9%) in this group. The difference of the incidence of urticaria between this group and the control was again statistically significant with 7% of significance level.
Read full abstract