Why is normal saline the only solution used for blood transfusions? How come lactated ringers or Normosol-R cannot be use with packed red cells. This is the practice at my hospital, let me know if you have seen different and why. Thanks.
The main reason you cannot utilize LR because the calcium in the LR will bind to the citrate in the blood and cause clumping of the RBCs this is also why you give 1gram of calcium after every 4 transfusions, becuase the citrate that is infused will bind to calcium in the body. Tonicity plays a role but a minor role as upposed to calcium.