The in vitro effects of storage of platelets prepared from 4 or 6 pooled buffy coat (BC) units and stored in a platelet storage medium consisting of 30-40% of CPD plasma or alternatively half-strength citrate CPD (0.5 CPD) plasma and 60-70% of different alternative platelet additive solutions (PASs) were evaluated. Measurements of mean platelet volume, pH, pO2, pCO2, bicarbonate, glucose, lactate, ATP, total adenine nucleotide content, extracellular lactate dehydrogenase or adenylate kinase activity, as markers for disintegration of platelets, and extracellular beta-thromboglobulin, as a marker for activation of platelets, were included in the in vitro studies. Previous studies indicated that a reduction of the citrate concentration from the standard 21 to 8 mmol/l is associated with a significant reduction of the consumption of glucose and production of lactate. Alternatively, similar effects can be obtained by the addition of acetate. In a preliminary paired study, the effects of different concentrations of acetate were tested. In an additional paired study, the effects of CPD plasma in combination with either saline or a PAS containing NaCl (115.5 mmol/l), citrate (10 mmol/l), and acetate (30 mmol/l), pH 7.2 (PAS-2) were evaluated. 0.5CPD plasma in combination with either PAS-2 or a nonacetate PAS (PAS-1) were also tested. The storage of platelets in 0.5CPD plasma was used as a reference. The conclusions are: (1) A minimum acetate concentration of 30 mmol/l is needed to counteract the effects of citrate on the production of lactate. (2) pH and the bicarbonate buffering capacity are significantly better maintained in PAS-2 than in PAS-1.(ABSTRACT TRUNCATED AT 250 WORDS)