Haemolysis Generated with the Use of Glass Bottles Instead of PVC, DEHP-Free Blood Collection Bags in the Oxygen-Ozone Therapy

This study investigates the safety implications of using glass bottles versus PVC, DEHP-free plastic bags for autologous blood collection in major autohaemotherapy with oxygen-ozone (O 2 -O 3 -MAHT). Concerns have arisen regarding increased haemolysis when blood is collected in glass containers, particularly due to high shear stress, surface irregularities and turbulence associated with vacuum-based collection. Historical data from transfusion medicine already established that glass induces higher red blood cell (RBC) rupture rates, a finding confirmed through mathematical modelling and simulations in this study. The release of haemoglobin and formation of meta-haemoglobin, both pro-inflammatory mediators, pose potential risks to patient safety. The authors applied ordinary differential equations (ODEs) to model haemolysis, biochemical stability and inflammatory responses, revealing that plastic bags offer superior preservation of RBC integrity and reduce inflammation risks. Comparative data on foam formation, albumin adsorption and oxygenation efficacy further reinforce the advantage of plastic containers. Forecast modelling suggests that treatment failure and safety risks increase significantly with glass use, particularly at higher ozone doses. The study concludes that DEHP-free plastic bags provide a more reliable, safe and biocompatible method for O 2 -O 3 -MAHT and recommends phasing out glass bottles to minimize haemolysis and ensure the therapeutic efficacy of medical ozone procedures.