Transfusion
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When red cells are stored as suspensions in artificial preservative solutions such as those consisting of saline, adenine, and glucose, increased hemolysis of the red cells occurs in vitro, a phenomenon that is readily prevented by the addition of mannitol. The mechanism by which mannitol prevents hemolysis is unknown. The authors have examined the possibility that mannitol prevents hemolysis by prevention of osmotic swelling of red cells that might otherwise increase their volume beyond their critical hemolytic volume. ⋯ Moreover, increasing the volume of the stored red cells acutely by osmotic means results in relatively little additional hemolysis. These findings make it appear unlikely that simple osmotic lysis is the cause of hemolysis in stored cells. Some other stabilizing effect of mannitol that may or may not be related to its osmotic effect must play a role.
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Electrocardiographic (ECG) monitoring was performed on 291 donors during apheresis. Twenty-one donors (7.2%) had clinical symptoms such as discomfort, nausea, chill, numbness, and paresthesia, and 13 of this group exhibited ECG abnormalities, such as tachycardia, bradycardia, and other abnormal wave patterns. The donors with tachycardia and slight bradycardia had no symptoms. ⋯ These changes were not associated with symptoms. Only three of these donors complained of discomfort or chest heaviness. The abnormal waves appeared more often in granulocytapheresis donors than in plateletapheresis donors.