Historical significance
Until the beginning of the 20th century, blood transfusion was extremely difficult due to its rapid clotting outside the bloodstream. A breakthrough occurred in 1914, when the researcher A. Huston (Hustin A.) discovered the unique property of sodium citrate (trisodium citrate) to block coagulation.
This discovery radically changed transfusiology. It became possible to abandon direct transfusion (from person to person in real time) and switch to indirect transfusion. Medical professionals were able to harvest blood in advance, build up reserves, and safely store and transport it over long distances. Notably, sodium citrate remains a basic component of most preservatives in modern medicine as well.
Preparation and composition of preservatives
Preserved blood is prepared by mixing whole donor blood with special solutions. To prevent bacterial contamination, antibiotics are added to the mixture. The finished mixture is stored in refrigerators under strict temperature control at 4–6 °C.
The base solution consists of two key components mixed with blood in a 1:4 ratio:
- Stabilizer: sodium citrate plays this role. Its main task is to bind free calcium ions ($Ca^{2+}$) in the plasma, which interrupts the coagulation cascade and keeps the blood in a liquid state.
- Preservative: carbohydrates such as dextrose or sucrose are used as a nutrient medium. They are necessary to maintain energy metabolism and erythrocyte viability while in the container.
Shelf life and component stability
The lifespan of blood cells outside the body directly depends on the type of preservative solution used. For example, the classic Glugicir solution ensures blood preservation for 21 days, whereas the use of the Ciglyfad solution extends this period to 35 days.
During storage, various blood elements behave differently:
- Least stable: clotting (hemostasis) factors and immune components. They degrade and lose activity in the very first days.
- Most stable: the oxygen-carrying function. Erythrocytes are able to perform their main respiratory task even at late stages of storage.
Clinical application
Due to the different rates of degradation of cellular and plasma elements, the expiration date of a blood bag dictates the indications for its use. The physician must choose the product based on the specific clinical task:
- To ensure hemostasis (stop bleeding), the most "fresh" blood with a shelf life of no more than 2–3 days is required, while clotting factors are still active in it.
- In acute blood loss and hypoxia, it is optimal to use blood with a short shelf life — from 3 to 5 days.
- For immunocorrection, the use of components with a shelf life of no more than 5–7 days is permitted.
Briefly: answers to topical questions
What is the complete chemical composition of the Glugicir preservative solution?
The complete chemical composition of the Glugicir solution is not detailed in the sources, but the basic components of blood preservative solutions are provided.
- Sodium citrate acts as a stabilizer, binding calcium ions and preventing clotting.
- Dextrose and sucrose act as preservatives, providing nutrition for erythrocytes.
The preservative is mixed with blood in a 1:4 ratio. When using Glugicir solution, the shelf life of blood at a temperature of 4–6 °C is 21 days.
For quick memorization of clinical application timeframes, use the "two-day step" (2-5-7): Hemostasis (up to 2-3 days) → Hypoxia (3-5 days) → Immunocorrection (up to 5-7 days).
Class and exam questions
What substance is used to prevent clotting of the collected blood?
Sodium citrate is used as the primary stabilizer. It chemically binds calcium ions, which are critically necessary for the coagulation process.
Why is dextrose added to the preservative solution?
Dextrose and other sugars (e.g., sucrose) serve as a nutrient source for erythrocytes. They support cell metabolism while outside the body.
Which blood function is preserved the longest during conservation?
The oxygen-carrying function has the highest stability. At the same time, hemostasis and immune factors are lost first.
What else to study on this topic
- Mechanism of blocking the coagulation cascade by sodium citrate
- Comparative characteristics of Glugicir and Ciglyfad solutions
- Degradation of coagulation factors during prolonged blood storage
- Technique and rules of indirect blood transfusion
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Other topics in the section "CHAPTER 6. BLOOD TRANSFUSION"
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