Effect of N-Acetylcysteine, Ascorbic Acid, and a Vitamin E Analog on Oxidative and Storage Lesions in Canine Packed Red Blood Cells

Objective

To describe storage and oxidative lesions in canine packed red blood cells (pRBCs) during routine storage with additives, including saline, N-acetylcysteine (NAC), ascorbic acid (AA), and vitamin E analog (VE).

Design

Prospective, comparative study of canine pRBCs with or without antioxidant additives during routine 42-day storage.

Setting

University teaching hospital.

Animals

Nine leukoreduced units of canine pRBCs were aseptically separated into three aliquots (Groups 1, 2, and 3) on the same day as collection (day 0). All aliquots were shipped overnight and received by the investigators on day 1.

Interventions

Antioxidants (or control solution) were added on day 1, with three treatment groups that included saline (control, Group 1), NAC and AA (Group 2), and AA and a VE (Group 3).

Measurements and Main Results

Blood was collected from each aliquot on day 1, before the addition of antioxidants for baseline measurement of glutathione and intraerythrocytic reactive oxygen species (ROS). Additional samples were collected from each aliquot on days 7, 28, and 42. Type 3 fixed-effects tests were used to compare the impact of group and time on each measurement. All groups showed storage lesions and glutathione depletion by day 42 compared with baseline, regardless of the antioxidant additive. Intraerythrocytic ROS accumulation was lower in Group 3 (AA and a VE) compared with other groups at all time points after baseline (p < 0.0001).

Conclusions

The addition of AA and a VE to canine pRBCs reduced ROS accumulation but did not prevent glutathione depletion during routine storage. Further studies using antioxidants as additives in canine pRBCs are warranted.