Smoking fewer than 20 cigarettes per day and remaining abstinent for more than 12 hours reduces carboxyhemoglobin levels in packed red blood cells for transfusion

Renata E Boehm; Bruno D Arbo; Denise Leal; Alana W Hansen; Rianne R Pulcinelli; Flávia V Thiesen; Almeri M Balsan; Tor G H Onsten; Rosane Gomez

doi:10.1371/journal.pone.0204102

Smoking fewer than 20 cigarettes per day and remaining abstinent for more than 12 hours reduces carboxyhemoglobin levels in packed red blood cells for transfusion

PLoS One. 2018 Sep 26;13(9):e0204102. doi: 10.1371/journal.pone.0204102. eCollection 2018.

Authors

Renata E Boehm^{1

2

3}, Bruno D Arbo³, Denise Leal⁴, Alana W Hansen³, Rianne R Pulcinelli³, Flávia V Thiesen⁴, Almeri M Balsan², Tor G H Onsten², Rosane Gomez^{1

3}

Affiliations

¹ Postgraduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.
² Hemoterapy Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
³ Postgraduate Program in Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
⁴ School of Pharmacy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

Abstract

Background: The prevalence of smokers among blood donors and the effect of smoking on the quality of donated blood have not been extensively explored. In the present study, we determined the prevalence of smoker donors in a large blood bank in Southern Brazil and evaluated the quality of packed red blood cells (RBCs) from these donors through recommended quality control tests and measurement of carboxyhemoglobin (COHb) levels. We then assessed the influence of smoking habits and abstinence before donation on these parameters.

Material and methods: An observational study was conducted to determine the prevalence of smoking donors, while a prospective cohort study compared conventional hematological and serological parameters and COHb levels at 0, 15, and 30 days after donation in RBCs donated by smokers (N = 31) and nonsmokers (N = 31) and their association with smoking habits and abstinence before donation.

Results: Of 14,428 blood donations received in 1 year, 5.9% were provided by smokers. Storage over time slightly altered some quality parameters, such as hematocrit, hemoglobin, hemolysis, and COHb levels, in RBC packs. COHb levels were higher in RBC packs from smokers (8%) than from non-smokers (2%), and increased as a function of the number of cigarettes smoked daily and time elapsed since the last cigarette smoked before donation. Lower levels were found in RBC packs from donors who smoked fewer than 20 cigarettes per day or remained abstinent for more than 12h before giving blood.

Conclusion: Although cigarette smoke had no significant effect on blood quality parameters such as hematocrit, hemoglobin, or hemolysis, it quadrupled COHb levels in packed RBCs. Abstinence from smoking for more than 12h or smoking fewer than 20 cigarettes daily helped decrease COHb levels.

Implications: Given the increasing prevalence of tobacco use worldwide, we suggest blood banks recommend 12h of tobacco abstinence before donation and analyze COHb levels in donated blood as an approach to reduce risk for high-risk recipients.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Blood Banks
Blood Donors
Blood Transfusion*
Carboxyhemoglobin / metabolism*
Cigarette Smoking / blood*
Erythrocytes / metabolism*
Female
Humans
Male

Substances

Carboxyhemoglobin

Grants and funding

This work was supported by a grant from the Fundo de Incentivo à Pesquisa e Eventos (FIPE)/HCPA and Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq (RG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.