Post Hoc Analysis of Experimental Studies on Hemolysis Marker Levels in Red Blood Cells Infused through Manual and Electronic Flow Control Devices

Highlights RBC transfusions are common but carry patient risks. This study compares hemolysis in RBCs infused with manual and electronic devices. Electronic devices significantly reduced total hemoglobin levels post-infusion. Manual devices increased free hemoglobin and hemolysis, particularly at 10 mL/h. Abstract Aim: In this study, we aims to compare levels of hemolysis markers in red blood cells (RBCs) before and after infusion through manual and electronic flow control devices. Methods: A post hoc analysis was conducted on experimental studies involving 102 experimental situations with RBCs, randomly allocated into groups to assess the impact of infusion flow control devices (manual versus electronic) at rates of 10 and 100 mL/h on biological markers of hemolysis. The dependent variables analyzed included hematocrit (%), total hemoglobin (g/dL), free hemoglobin (g/dL), potassium (mmol/L), and degree of hemolysis (%). Inferential statistics ( P ≤ 0.05) were employed for data analysis. Results: The analysis encompassed 102 experimental situations, yielding 204 aliquots of RBCs designated as control and postinfusion samples. Control samples exhibited consistent results across device types. In postinfusion samples, a significant reduction in total hemoglobin levels ( P < 0.001) were observed in concentrates infused via electronic devices, with total hemoglobin levels decreasing by over 10 g/dL. Conversely, levels of free hemoglobin and the degree of hemolysis were notably higher with manual flow control devices, particularly at a rate of 10 mL/h ( P < 0.001). Conclusion: Electronic flow control devices demonstrated a greater effect in reducing total hemoglobin level after infusion. The combination of a microdrop device with an infusion rate of 10 mL/h resulted in the most significant increases in hemolysis markers and free hemoglobin levels.