Feasibility of photoacoustic imaging for the non-invasive quality management of stored blood bags

Abstract

Background and objectives: During the in vitro storage of red blood cells (RBCs), unfavourable changes (storage lesions) cause a rapid consumption of intracellular diphosphoglycerate. The latter deregulates the oxygen-haemoglobin binding potential, subsequently increasing oxygen saturation (SO₂ ) and membrane degradation, transforming RBCs from biconcave discs to rigid spherical bodies (spheroechinocytes). Current laboratory techniques invasively extract RBC samples to assess the quality of red cell concentrate (RCC) units. Optical technologies could provide a means of assessing quality non-invasively.

Materials and methods: A photoacoustic (PA) imaging technique was developed for acquiring the SO₂ of blood bags non-invasively. Seven RCC units were monitored every 3-5 days until expiry (6 weeks). Measurements were validated against a conventional blood gas analyzer (BGA). Using an image flow cytometry assay, morphological profile trends were compared against the SO₂ trends during blood bag storage.

Results: A strong correlation (r² ≥ 0·95) was found when comparing temporal data between PA and BGA SO₂ measurements. Inter-sample PA variability was found to be similar to that produced by BGA (±0·8%). A strong correlation was found to exist between the temporal changes in SO₂ and relative spheroechinocyte population (0·79 ≤ r² ≤ 0·97).

Conclusion: This study suggests that PA imaging can non-invasively track the SO₂ of stored RBCs non-invasively. By longitudinally monitoring the change in SO₂ , it is possible to infer the effects of the storage lesion on RBC morphology. This non-invasive monitoring technique allows for the assessment of blood bags, without compromising sterility pre-transfusion.

Keywords: oxygen saturation; patient blood management; quality control; quality management; transfusion medicine.