Enhanced O 2 availability in platelet concentrates stored for neonatal transfusion is independent of agitation: Evidence from direct oximetry and Fickian diffusion modelling

Background and Objectives: Platelet transfusions are essential for mitigating the bleeding risk of neonatal patients with thrombocytopenia. As neonatal patients have a small blood volume, adult therapeutic dose platelet units are split into reduced‐volume storage containers to maximize the use of the donated product and reduce donor exposure. The shelf‐life of platelets stored in reduced‐volume containers, however, is limited to 5 days. Agitation in platelet concentrate (PC) storage is thought to promote gaseous exchange by maintaining a gradient of O2 across the bag film; however, recent studies have shown that agitation‐induced shear promotes the progressive decline of platelet quality over storage. Materials and Methods: Electron paramagnetic resonance oximetry and Fickian diffusion modelling of O2 were used to investigate the differences in O2 availability, by assessing the O2 concentration, oxygen consumption rate (OCR), influx of O2, total PC OCR and O2 distribution in PCs stored under routine conditions in neonatal (Macopharma, VQE605B) versus adult (Haemonetics, ATSBC1ESE) PC storage containers. The influence of agitation on neonatal PC storage was evaluated. Results: Results indicate neonatal PCs experience significantly higher O2 availability compared to adult PCs and can withstand greater insult to their ambient O2 concentration. Adjusting the agitation frequency of neonatal PCs stored from 20 to 400 rpm had no detrimental effect on O2 availability, compared to storage at 60 rpm. Conclusion: Neonatal PCs can maintain higher O2 availability and tolerate reduced agitation without compromising oxygenation; therefore, reduced agitation strategies may be a feasible option to minimize shear during storage without compromising O2 availability.