Abbott Laboratories Abbott Park, Illinois, United States
Background/Case Studies: Blood product donation results in acute volume loss. Donors respond with regulatory mechanisms moving fluid into the vascular space to compensate. Donors are generally offered beverages to counteract losses and prevent immediate and late-onset vasovagal donor reactions. Several beverage options are offered to donors including water, juices, sodas, and sports drinks; however, electrolyte (lytes) and sugar profiles of these solutions vary from donation losses. This study aims to compare lyte and sugar profiles of some current beverages offered to blood product donors relative to amount lost in donation.
Study
Design/Methods: Product (source: US “Circular of Information for the Use of Blood and Blood Components) total lytes, glucose (glc), and albumin loss without infusionare calculated for 450mL whole blood at 12.5g/dL & 13.0g/dL Hgb and 5.5X1010 platelets, apheresis platelet unit in 200mL & 400mL plasma, and 400mL & 600mL plasma units. US national reference laboratory lytes (Na, K, Cl, HCO3, Ca, Mg, & P), glc, and albumin normal reference values are used to calculate content range per donation. Cellular lytes were calculated using minimum cell count per product (source RBC: HCT, MCV, 27pg/cell; PLT: Circular) and published data of individual cells to estimate total content. Beverage composition derived from manufacturers or USDA Food Data Central website.
Results/Findings: See Table 1 for summary. Lyte loss is driven by product plasma as opposed to intercellular loss. Total lyte loss ranged from 2314mg (200mL apheresis platelet unit) to 5560mg (600mL plasmapheresis). Cellular lyte loss is greatest in apheresis platelet unit. Glc and protein losses ranges from 140mg and 7.0g (200mL apheresis platelet unit) to 840mg and 30g (600mL plasmapheresis), respectively. US retail beverages are not required to label all lytes (Cl, Ca, Mg, P) and have various carbohydrates listed as “sugars”.Highestlyte content is found in oral rehydration solution (ORS) next orange juice then apple juice. Tonicity is driven by carbohydrate content for beverages listed, with typical sports drinks in the isotonic range, juices and sodas in the hypertonic range, and drinks like ORS or no-sugar lyte drinks hypotonic. Conclusions: To our knowledge this is the only compilation of donation product loss to include intracellular content. While intercellular loss isn’t thought to impact blood volume homeostasis physiologic mechanisms, content is ultimately a net loss, thus accounted for here. Varying degrees of lyte and carbohydrate equivalency are identifiedbetween blood products and beverages with the closest approximation being ORS. Since tonicity,lyte, and sugar content of a beverage influence gastric emptying and rate of intestinal absorption, the data presented here suggests considerationforbeverageselection pre- or post-donation and potential research exploring to adverse reactions related to that selection and timing.
