Challenges and Solutions:
Veterinarians and veterinary technicians administer canine blood transfusions when treating many conditions, from tissue hypoxia and immune-mediated hemolytic anemia to decreased erythrocyte production1. Despite being a common and vital procedure, there is debate among veterinary clinicians surrounding the safest and most effective administration methods for blood products to ensure patients receive the full benefit of their transfusions.
Ensuring RBC Cell Viability for Blood Transfusions
Delivering blood products with the correct dosage and maximum red blood cell (RBC) survival is critical for effectiveness of a transfusion. When the rate of a blood transfusion fluctuates, there is an increased risk of volume overload, immunologic complications, or prolonged exposure of RBCs to room temperature that can increase the risk of bacterial contamination2.
While pumps can be used to control delivery rate for blood administration, research increasingly shows that they can also create the potential for damaging red blood cells. In a 2011 study by McDevitt DVM, syringe and volumetric pumps were found to decrease the survival of RBCs when measured 24 hours after a transfusion. When the transfusion was administered through a volumetric pump, only 50% of the canine patients had a viable population of red blood cells after one day. The survival rate increased slightly when using a syringe pump, but only one of the seven patients had detectable red blood cells at the end of the 24 hour period. Using gravity administration, there was a 100 percent RBC survival rate at 24 hours post-transfusion1.
Achieving Precise Monitoring for Gravity Blood Transfusions
As McDevitt demonstrated, using gravity to administer blood transfusions ensures maximal survival rates of RBCs. However, it is difficult to be confident in the accuracy and safety of gravity drips without using a monitoring technology.
Factors such as tubing set “creep” and the difficulty of setting rates accurately with manual drop counting can create challenges in ensuring the desired transfusion rate is maintained3. External factors such as changes in atmospheric pressure, patient position, clot formation and infiltration can also influence the rate of infusion4. The risks created by these potential errors is so high that Kenichiro Yagi, a Veterinary Technician who has worked in critical care and small animal internal medicine for 15 years, recommends having at least one member of the veterinary staff dedicated to monitoring the patient and rate throughout an entire transfusion when using gravity if a monitoring technology is not available2.
DripAssist Veterinary Infusion Rate Monitor
The solution offered by Yagi to ensure RBC survival while preventing errors in canine blood administration is the use of the DripAssist Veterinary Infusion Rate Monitor to monitor transfusions given via gravity. DripAssist is a small, portable rate monitor that slides onto gravity administration sets for fluids, medication and blood products. DripAssist eliminates the need for manual counting and precisely monitors the transfusion rate and total volume given. An optional alarm can also let technicians know when the rate changes or a problem arises with the transfusion. Because it attaches to gravity sets, the device combines the highest level of cell viability with continuous and precise monitoring.
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