Compatibility of Lactated Ringer’s Solution human blood products containing red blood cells: a systematic review protocol

Description
Title: Compatibility of Lactated Ringer’s Solution human blood products containing red blood cells: a systematic review protocol
Authors: Wolfe, Dianna
English, Shane
Fergusson, Dean
Kanji, Salmaan
Lalu, Manoj
Mendis, Nick
Tinmouth, Alan
McIntyre, Lauralyn
Date: 2016-08-31
Abstract: Domain being studied: Crystalloid fluids and red-cell-containing blood products are commonly used for resuscitation of patients in hemorrhagic shock. In Canada, two crystalloid fluids—Lactated Ringer’s solution (LRS) and normal saline (NS)—account for over 90% of crystalloids used, with LRS having potential clinically relevant advantages over NS in initial resuscitation efforts. However, current transfusion guidelines advise against co-administration of red-blood-cell containing products with LRS because of the potential for clot formation, potentially leading to negative patient outcomes. The evidence supporting these guidelines is conflicting. Original studies conducted in the 1970s and 80s demonstrated the potential for small amounts of calcium in LRS to overwhelm anticoagulants in whole blood for transfusion, resulting in clot formation at higher LRS-to-blood product ratios. Research published since 2000 has suggested that certain blood product additives and rapid transfusion methods currently in use may reduce the potential for LRS to induce coagulation. A systematic review of the available literature is necessary to summarize the evidence in a methodologically rigorous manner.
URL: http://hdl.handle.net/10393/35114
CollectionIRHO - Publications // OHRI - Publications
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