Does transfusion using a syringe infusion pump and small-gauge needle cause hemolysis?

Hemolysis of two- and nine-day-stored sedimented red blood cells (hematocrit 65%), infused by a constant-rate syringe delivery pump through a 25-gauge needle was investigated. Fifteen-ml aliquots of blood were pumped through the system at flow rates of 10.6, 20.5, and 70 ml/hour. Plasma-free hemoglobin and potassium were measured and compared to controls. Significant red blood cell hemolysis occurred during passage through this infusion system, and the amount of hemolysis was greater with nine-day-stored cells. These cells showed more hemolysis with slower flow rates, but the two-day-stored cells were not affected by rate of flow.