The use of Citrate Phosphate Dextrose (CPD-A) in blood in the perfusate affects which parameters?

Citrate Phosphate Dextrose (CPD-A) is an anticoagulant solution commonly used in blood storage, and its role in perfusion is significant. When blood is mixed with CPD-A, citrate acts as an anticoagulant by chelating calcium ions in the blood. This chelation process effectively decreases the levels of ionized calcium in the perfusate. Ionized calcium is crucial for various physiological processes, including blood coagulation and cardiac function.

The reduction of ionized calcium due to citrate infusion can lead to a state of calcium-deficiency, which is why it is important for perfusionists to monitor calcium levels during procedures involving CPD-A to prevent complications. Therefore, the impact of CPD-A on ionized calcium is a central aspect of understanding its role in blood perfusion and storage.

In contrast, while CPD-A can influence other parameters indirectly, its primary and most direct effect is on ionized calcium because of the way citrate interacts with calcium ions in the blood. The other parameters listed, such as potassium, total carbon dioxide, and blood sugar, may be influenced by the metabolic processes or the physiological responses of the patient, but they do not have the same direct relationship as that of CPD-A