Enhanced O availability in platelet concentrates stored for neonatal transfusion is independent of agitation: Evidence from direct oximetry and Fickian diffusion modelling.

Background And Objectives: Platelet transfusions are essential for mitigating the bleeding risk of neonatal patients with thrombocytopenia. As neonatal patients have a small blood volume, adult therapeutic dose platelet units are split into reduced-volume storage containers to maximize the use of the donated product and reduce donor exposure. The shelf-life of platelets stored in reduced-volume containers, however, is limited to 5 days. Agitation in platelet concentrate (PC) storage is thought to promote gaseous exchange by maintaining a gradient of O across the bag film; however, recent studies have shown that agitation-induced shear promotes the progressive decline of platelet quality over storage.

Materials And Methods: Electron paramagnetic resonance oximetry and Fickian diffusion modelling of O were used to investigate the differences in O availability, by assessing the O concentration, oxygen consumption rate (OCR), influx of O, total PC OCR and O distribution in PCs stored under routine conditions in neonatal (Macopharma, VQE605B) versus adult (Haemonetics, ATSBC1ESE) PC storage containers. The influence of agitation on neonatal PC storage was evaluated.

Results: Results indicate neonatal PCs experience significantly higher O availability compared to adult PCs and can withstand greater insult to their ambient O concentration. Adjusting the agitation frequency of neonatal PCs stored from 20 to 400 rpm had no detrimental effect on O availability, compared to storage at 60 rpm.

Conclusion: Neonatal PCs can maintain higher O availability and tolerate reduced agitation without compromising oxygenation; therefore, reduced agitation strategies may be a feasible option to minimize shear during storage without compromising O availability.