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Fresh and Stored Citrated Blood for Exchange Transfusions

LAGRIMAS SANCHEZ, M.D.; ROBERT E. CARTER, M.D.
Am J Dis Child. 1962;103(4):597-602. doi:10.1001/archpedi.1962.02080020610010.
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The technique of exchange transfusion in infants has been perfected through experience with thousands of procedures in medical centers in this country and abroad. Reliable methods have been developed and used with gratifying results. In the great majority of these transfusions, an anticoagulant solution of acid citrate dextrose USP (ACD solution) has been used for the donor blood, although several authors have reported using heparinized blood with satisfactory results.1-5

Complications during exchange transfusion due to high potassium levels in stored blood were recognized soon after the procedure came into general use. The need for caution in using stored blood has been emphasized repeatedly,1,6-10 although in at least one study blood stored up to 4 days did not cause hyperkalemia in the recipient infants despite moderately elevated potassium levels in the blood at the time it was used.8 A variety of complications have been ascribed directly and indirectly to

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