Page 604 - Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice

592 SPECIAL THERAPY

EQUIPMENT AND SUPPLIES bag systems. Maximal storage time for feline blood in
FOR COLLECTION OF BLOOD CPDA-1 has yet to be determined but may be as long
15
as 35 days.
SKIN PREPARATION ACD
Strict aseptic technique must be used during the blood Acid citrate dextrose or anticoagulant citrate dextrose
collection process to prevent contamination of blood (ACD) formula B can be used to store either canine or
29,79
with microorganisms. Whenever possible, solutions and feline blood. It can be purchased in 500-mL bags
equipment used for the collection process should be sin- and placed in syringes for collection of blood. Cat and
gle-use products to prevent inadvertent contamination of dog red blood cells maintain adequate viability following
55
blood. After clipping the hair over the venipuncture storage in ACD for 30 and 21 days, respectively.
site, the skin is surgically scrubbed. The ideal skin prepa- Additive Solutions
ration regimen is yet to be determined in animals; how-
ever, in human blood donors, a 30-second, 70% Additive solutions are contained in a multibag system
isopropyl scrub followed by a 2% iodine tincture resulted containing citrate phosphate dextrose (CPD) or citrate
in better skin surface disinfection than alcohol followed phosphate dextrose 2 (CPD-2) as the anticoagulant.
by chlorhexidine or green soap. 44 The phlebotomist The additive solution is contained in a bag separate from
wears sterile surgical gloves and performs venipuncture the main bag and is added to PRBCs after the plasma is
without touching the scrubbed area. removed. Additive solutions that have been evaluated
in dogs are Adsol (Fenwal Laboratories, Baxter Health
ANTICOAGULANT SOLUTIONS Care Corporation, Deerfield, Ill.) and Nutricel (Miles
Several different solutions are available to anticoagulate Pharmaceutical Division, West Haven, Conn.). 123,125
and preserve blood for transfusion and species-specific Additive solutions have not been evaluated for storage
storage times are listed (Table 24-1). Anticoagulants pro- of feline blood, but are sometimes used as storage media
vide no nutrients to preserve red cell metabolism during for feline red blood cells.
storage.Bloodcollectedinanticoagulantsshouldbetrans- LEUKOREDUCTION FILTERS
fused immediately. Anticoagulant-preservative solutions
have been designed to provide nutrients to maintain red White blood cells are responsible for some adverse effects of
blood cell function during storage. transfusionanddonotcontributetotransfusionefficacy(see
“Adverse Effects of Transfusion”). An integral filter to
CPDA-1 remove white blood cells from whole blood is incorporated
One common anticoagulant solution for preservation of into some blood bag systems. One system has been
canine red blood cells, citrate phosphate dextrose adenine evaluated using canine blood and effectively removed white
(CPDA-1), is found in commercially prepared, multiple- blood cells without affecting red blood cell viability. 13

TABLE 24-1 Anticoagulants and Preservatives for Blood

Canine Blood Ratio with Blood Storage Time at 0 -6 C

Anticoagulant
Heparin 625 U/50 mL blood For immediate transfusion
3.8% sodium citrate 1 mL/9 mL blood For immediate transfusion
Anticoagulant-Preservative
CPDA-1 1 mL/7 mL blood 20 days
ACD “B” 1 mL/7-9 mL blood 21 days
Additive solutions 100 mL/250 mL packed red blood cells 37-42 days
Feline Blood
Anticoagulant
Heparin 625 U/50 mL blood For immediate transfusion
3.8% sodium citrate 1 mL/9 mL blood For immediate transfusion
Anticoagulant-Preservative
ACD “B” 1 mL/7-9 mL blood 30 days
Additive solutions Not evaluated