Effect of Red Cell Concentrate Storage on Electrolyte Levels and Hematological Parameters

Abstract

Objective: To observe the changes in Electrolyte levels and Hematological Parameters in Stored Red Cell Concentrate (RCC).

Study Design: Analytical Cross-Sectional Study.

Place and Duration of Study: Blood Bank and Department of Pathology, Combined Military Hospital, Multan, Pakistan, from Jan to Aug 2025.

Methodology: Stored RCC units prepared from healthy voluntary blood donors and stored under standard blood bank conditions (2–6°C) in CPDA-1 triple bags were selected for study. One hundred and fifty RCC units were sampled, and a 5 mL sample was aseptically withdrawn from each RCC unit on the donation day, 20th and 35th days. Electrolyte parameters, including potassium, sodium, calcium, and chloride, along with pH and Hematological parameters such as mean corpuscular volume (MCV) and red cell count, were measured, and the trend of change was compared between all three samples from designated bags.

Results: RBC count demonstrated 11.4% decline with median RBC 4.88(0.66)×10⁹/L on Day-1 to 4.32(1.15)×10⁹/L by Day-35 (p<0.001). In contrast, MCV increased 8.8%, from median 84.50(14.00) fL on Day-1 to 92.00(10.00) fL on Day-35 (p<0.001). Sodium decreased 3.8% from 142.00(2.85) mmol/L on Day-1 to 136.52(1.46) mmol/L on Day-35 and Potassium increased markedly 248.1% from median 4.03(0.85) mmol/L on Day-1, to 14.03(0.94) mmol/L on Day-35 (p<0.001). Calcium and Chloride levels showed 7.5% and 18.3% decrease respectively, whereas pH decreased 6% from 7.43(0.67) on Day-1 to 6.98(0.60) on Day-35 (p<0.001).

Conclusion: There were significant hematological and biochemical alterations in RCC during storage, proportional to the duration of the stored RCC bag.