• Ling Li, Jiangcun Yang, Yang Sun, Qianli Dang, Cuixiang Xu, Ping Chen, Ting Ma, and Jiangkang Ren.
• Department of Transfusion Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
• J Crit Care. 2015 Feb 1;30(1):220.e1-12.

PurposeThis study aimed to determine the optimal composition and timing for the administration of blood supplements during in vivo blood transfusion with red blood cells suspension (pRBC), fresh frozen plasma (FFP), and apheresis platelet (PLT) administered for the correction of anemia and coagulation dysfunction caused by in vitro hemodilution.Materials And MethodsWe collected blood samples from 24 healthy volunteers and prepared various dilutions of whole blood with normal saline: 9:1, 8:2, 7:3, 6:4, 5:5, 4:6, 3:7, 2:8, and 1:9. The diluted blood samples were then supplemented with blood components at various proportions and then analyzed to determine the values of the routine blood indices, coagulation indices, and thromboelastogram measures.ResultsAt hemodilutions of 40%, 50%, and 60%, the hemoglobin, coagulation indices, and platelet number and function reached critical levels, necessitating supplementation with pRBC, FFP, and PLT, respectively. When hemodilution was 90%, the supplementation required was approximately 1:1.3:0.9 of pRBC/FFP/PLT.ConclusionThe use of pRBC, FFP, and PLT in appropriate proportions can correct the blood coagulation dysfunction and anemia caused by in vitro hemodilution, and these proportions can be used as guidelines for in vivo massive transfusion.Copyright © 2014 Elsevier Inc. All rights reserved.

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