Increased Pulmonary Arteriovenous Shunting in Humans Following Blood Transfusion

Publisher Website
Google Scholar
Abstract
• Transfusion through standard filters to dogs of stored blood containing microaggregates results in an increase in pulmonary arteriovenous shunting (Qs/Qt) and a decreased diffusion capacity of the lung for O2. These effects are due to microemboli that pass the filters and are prevented by use of Dacron wool (Swank) micropore transfusion filters. It was the purpose of this study to determine whether alterations in pulmonary shunting occur in humans following transfusion of stored blood through standard transfusion filters. In eight patients transfused over 20% of blood volumes through standard filters, Qs/Qtand alveolar-arterial O2tension differences increased significantly. These changes did not occur in patients transfused comparable amounts of blood through Dacron wool (Swank) filters or in patients transfused less than 20% of blood volumes. A direct correlation was found between the absolute percent change in Qs/Qtand the quantity of microaggregates passing the filter and present in the transfused blood. It is concluded that removal from stored blood of microaggregates by administration of the blood through effective micropore transfusion filters prevents an increase in Qs/Qtcaused by administration of such material. (Arch Surg113:947-950, 1978)