Circulatory haemodynamics after blood transfusion in chronic severe anaemia.

Sanghvi, L. M.; Kotia, K C; Sharma, Samar; Bordia, A; Jain, Yash

doi:10.1136/hrt.30.1.125

Cited by 12 publications

(4 citation statements)

References 10 publications

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“…13 In dogs, acute normovolemic reduction of hematocrit induces a large reduction of peripheral resistance without significant changes of cardiac output. 15 Finally, available data indicate that whole blood viscosity is also a correlate of left ventricular hypertrophy. 36 Although extrapolation of cross-sectional observations must be made with caution, results of the present study indicate that a 10-unit increase in hematocrit (e.g., from 35% to 45%) would be associated with an increase of 4-6 mm Hg in arterial pressure and with a twofold increased risk of hypertension.…”

Section: Discussionmentioning

confidence: 99%

Hematocrit, blood pressure, and hypertension. The Gubbio Population Study.

et al. 1992

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Baseline data from the Gubbio Population Study in north central Italy were used to investigate the relation of hematocrit to blood pressure and hypertension among 2,809 men and women aged 25-74 years. Independent of gender, age, and other confounders, the hypertensive group had a higher hematocrit than the nonhypertensive group (p<0.001). In comparison with the untreated hypertensive group, the hypertensive group being treated with diuretics or with other drugs only had similar mean hematocrit levels despite significantly lower blood pressures. Hematocrit was positively correlated with systolic pressure (r=0.085,p<0.01 andr=0.264,p<0.001 for men and women, respectively) and diastolic pressure (r=0.214, p<0.001 and r=0.266, p<0.001). In both sexes, whether or not the treated hypertensive group was included, age-adjusted prevalence of hypertension and average blood pressure were higher for persons in higher qulntiles of hematocrit (/><0.001). The association of hematocrit with blood pressure and hypertension was significant and independent of several confounders. The regression coefficient of blood pressure on hematocrit ranged between 0.410 and 0.620 mm Hg per unit of hematocrit for systolic pressure and between 0371 and 0.581 for diastolic pressure, depending on gender and whether the treated hypertensive group was included in multiple regression analysis. Based on exponentiation of the multiple logistic coefficient, prevalence of hypertension was at least two times greater for persons whose hematocrit levels were higher by 10 units. (Hypertension 1992^20-319-326) KEY WORDS • hematocrit • blood pressure • hypertension, essential • Gubbio population study H ematocrit is the most important determinant of whole blood viscosity. 1 Blood viscosity and vascular resistance affect total peripheral resistance to blood flow, 2 which is abnormally high in the established phase of primary hypertension.3 It has been reported that hematocrit is increased or normal in human hypertension*-9 and increased in rat genetic hypertension. 8 -10 In genetically hypertensive rats, it has also been shown that reduction of hematocrit with maintenance of blood volume reduces blood pressure.11 -13 Correspondingly, clinical studies have reported that increase of hematocrit is followed by increase in blood pressure and possibly onset of hypertension in anemic patients.14 - 20From the Division of Nephrology, First Medical School (M.C), University of Naples "Federico II," Naples; the Center for Epi Many clinical and experimental studies have been done on the relation between hematocrit and blood pressure, but the epidemiological literature does not identify hematocrit as an important independent correlate of blood pressure in general populations. The present study of men and women from the Gubbio Population Study in north central Italy 21 shows that a significant positive association exists between hematocrit and blood pressure or hypertension, independent of other factors related to these end points. MethodsIn the Gubbio Study, the target pop...

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Section: Discussionmentioning

confidence: 99%

Hematocrit, blood pressure, and hypertension. The Gubbio Population Study.

et al. 1992

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“…Blood transfusion is still the most important life-saving approach for critically ill patients with severe anemia, but a restrictive transfusion strategy should be followed according to current guidelines. However, there is compelling evidence that patients with CVD, treated acutely by blood transfusion, have a worsened outcome and show adverse events such as thromboembolism, allergic reactions, and fever, in addition to acute hemodynamic changes (such as elevated blood pressure and increased total blood volume and left ventricular work) ( 158 ). In case of repeated blood transfusions, additional transfusion-related complications arise, including acute lung injury, electrolyte disorders (hyperkalemia and hypocalcemia), and iron overload.…”

Section: Anemia and Cvd: Clinical Aspects And Therapeutic Approachesmentioning

confidence: 99%

Red Blood Cell Function and Dysfunction: Redox Regulation, Nitric Oxide Metabolism, Anemia

Kuhn

Diederich

Keller

et al. 2017

Antioxidants & Redox Signaling

335

250

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Significance: Recent clinical evidence identified anemia to be correlated with severe complications of cardiovascular disease (CVD) such as bleeding, thromboembolic events, stroke, hypertension, arrhythmias, and inflammation, particularly in elderly patients. The underlying mechanisms of these complications are largely unidentified.Recent Advances: Previously, red blood cells (RBCs) were considered exclusively as transporters of oxygen and nutrients to the tissues. More recent experimental evidence indicates that RBCs are important interorgan communication systems with additional functions, including participation in control of systemic nitric oxide metabolism, redox regulation, blood rheology, and viscosity. In this article, we aim to revise and discuss the potential impact of these noncanonical functions of RBCs and their dysfunction in the cardiovascular system and in anemia.Critical Issues: The mechanistic links between changes of RBC functional properties and cardiovascular complications related to anemia have not been untangled so far.Future Directions: To allow a better understanding of the complications associated with anemia in CVD, basic and translational science studies should be focused on identifying the role of noncanonical functions of RBCs in the cardiovascular system and on defining intrinsic and/or systemic dysfunction of RBCs in anemia and its relationship to CVD both in animal models and clinical settings. Antioxid. Redox Signal. 26, 718–742.

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“…[27] The reduction in the parameters except O 2 sat and blood pressure in response to blood transfusion in this study is consistent with previous reports in adult and children. [11,12,28,29] The HR and RR had the most easily measurable reduction compared with change in liver size. This easily measured difference in HR has been reported in previous works.…”

Section: Discussionmentioning

confidence: 99%

“…This easily measured difference in HR has been reported in previous works. [28,29] In contradistinction, the reduction in liver size became more measurable post transfusion. This may be due to the fact that the increase in HR and RR activated by neurohumoral mechanisms in response to decrease in oxygen carrying capacity (anemia) are easily reversed following blood transfusion.…”

Section: Discussionmentioning

confidence: 99%