Objectives: Hemolysis is a significant complication of extracorporeal membrane oxygenation (ECMO), with a reported incidence of 12.2%. The aims of this study were (1) to investigate hemolysis caused by saline-washed versus unwashed RBCs, (2) to determine in vitro the effects of saline washing on erythrocyte hemolytic markers and (3) to investigate hemolysis by centrifugal versus roller pumps.Study design: (1) To evaluate the effect of pre-transfusion saline-washing versus non-washing, the peak plasma-free hemoglobin (FHb) and total bilirubin in the first 3 days versus the next 4 days of ECMO were compared (2) Pre-and postsaline-washed RBCs were analyzed for K þ , hemoglobin, mean corpuscular volume, FHb and hemolysis at baseline and after 4 h of storage at 41C. (3) Over 10 000 neonatal ECMO cases were retrospectively reviewed to study the effect of pump type on hemolysis.Results: (1) The washed blood group had significantly more hemolysis within the first 3 days of ECMO. (2) Immediately after saline washing, the K þ and Hb concentrations were significantly decreased compared with unwashed blood, and these differences were maintained after 4 h. The osmotic fragility of washed RBCs after 4 h of storage at 41C was significantly higher than at baseline. (3) Hemolysis was reported more often in the centrifugal than in the roller pump group.Conclusions: (1) Using unwashed RBCs decreased hemolysis within the first 3 days of ECMO. (2) Saline washing, while decreasing the concentration of K þ in the plasma, significantly increases RBC membrane osmotic fragility. (3) Hemolysis is linked to the use of centrifugal pumps.
Vasopressin in cerebrospinal fluid has been measured in 27 fullterm newborns with hypoxic-ischemic encephalopathy. These newborns were divided into three groups according to the degree of neurological involvement, and they have been compared with a control group of 10 newborns. Determinations of vasopressin in cerebrospinal fluid and plasma were done by RIA. The cerebrospinal fluid vasopressin in asphyxiated newborns was higher than in the control group (p < 0.001); the mean concentration in the group of newborns classified as moderate or severe hypoxic-ischemic encephalopathy was higher than in the control group (18.7 pg/ml vs 4.66 pg/ml), and also higher than in the group classified as mild (14.2 pg/ml). Cerebrospinal fluid vasopressin values have a direct relationship to the plasmatic values at 12 hours of life (r = 0.76; p < 0.001). We concluded that vasopressin values in cerebrospinal fluid at 12 hours increase according to the clinical severity of the neonatal hypoxic-ischemic encephalopathy and that they have a strong relationship with plasmatic vasopressin.
Objective: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to observe the efficacy of yoga on insulin resistance in type 2 diabetes (T2D). Materials and methods: The present systematic review and meta-analysis were done following the PRISMA guidelines. Data were collected through specific keyword searches from eminent databases. The risk of bias in included studies was assessed, using the revised Cochrane risk-of-bias tool. Meta-analysis was performed using RevMan software. Forest plots were used to illustrate the study findings and meta-analysis results. Results: A total of six studies were finally included in this systematic review, where 375 participants were allocated to a yoga intervention with the control group, and the age range of participants was 15-75 years. In the yoga group compared to the control, there was a significant reduction in fasting blood glucose (FBG) by 33.02 mg/dL, post-prandial blood glucose (PPBG) by 62.54 mg/dL, fasting insulin by 4.95 µIU/mL and insulin resistance (HOMA-IR) by 2.81 in the meta-analysis. Conclusions: Regular yogic practice with oral hypoglycemic agents (OHA) have positive effects on insulin resistance compared to the control group (no regular exercise with OHA) in patients with type 2 diabetes.
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