Effects of fresh versus banked blood transfusions on microcirculatory hemodynamics and tissue oxygenation in the rat cremaster model

Gonzalez, Andrea Moreira; Yazici, Ilker; Kusza, Krzysztof; Siemionow, Maria

doi:10.1016/j.surg.2006.09.015

Cited by 35 publications

(15 citation statements)

References 21 publications

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“…In a preliminary study comparing the effect of fresh versus stored whole blood transfusion on microcirculatory flow parameters following hemorrhage in the rat cremaster muscle flap model, Arslan et al found that fresh blood was significantly more effective than banked blood at restoring the deficit in functional capillary perfusion created by acute hemorrhage (46). In a larger study using the same model, this group again found that functional capillary perfusion was more effectively restored by fresh whole blood following hemorrhage compared with stored blood (47). Additionally they found that transfusion of fresh whole blood restored the microcirculatory tissue oxygenation to baseline levels while transfusion of stored whole blood did not (9.5 mm Hg versus 8 mm Hg, p=0.02).…”

Section: Impact Of Rbc Transfusion On Regional Measures Of Tissue Oxymentioning

confidence: 94%

Impact of Red Blood Cell Transfusion on Global and Regional Measures of Oxygenation

Roberson¹,

Bennett‐Guerrero²

2012

Mount Sinai J Medicine

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Anemia is common in critically ill patients. While the goal of transfusion of red blood cells (RBCs) is to increase oxygen carrying capacity, there are contradictory results about whether RBC transfusion to treat moderate anemia (e.g. hemoglobin 7–10 g/dL) improves tissue oxygenation or changes outcomes. While increasing levels of anemia eventually lead to a level of critical oxygen delivery (DO2), increased cardiac output and oxygen extraction are homestatic mechanisms the body uses to prevent a state of dysoxia in the setting of diminished DO2 due to anemia. In order for cardiac output to increase in the face of anemia, normovolemia must be maintained. Transfusion of RBCs increases blood viscosity which may actually decrease cardiac output (barring a state of hypovolemia prior to transfusion). Studies have generally shown that transfusion of RBCs fails to increase oxygen uptake (VO2) unless VO2/DO2 dependency exists, e.g., severe anemia or strenuous exercise. Recently near-infrared spectroscopy (NIRS), which approximates the hemoglobin saturation of venous blood, has been used to investigate whether transfusion of RBCs increases NIRS measurements of tissue oxygenation in regional tissue beds (e.g., brain, peripheral skeletal muscle). These studies have generally shown increases in NIRS derived measurements of tissue oxygenation following transfusion. Studies evaluating the effect of transfusion on the microcirculation have shown that transfusion increases the functional capillary density. This article will review fundamental aspects of oxygen delivery and extraction, and the effects of RBC transfusion on tissue oxygenation as well as the effects of RBC transfusion on the microcirculation.

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Section: Impact Of Rbc Transfusion On Regional Measures Of Tissue Oxymentioning

confidence: 94%

Impact of Red Blood Cell Transfusion on Global and Regional Measures of Oxygenation

Roberson¹,

Bennett‐Guerrero²

2012

Mount Sinai J Medicine

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“…However, one recent preclinical experience suggests that rat RBCs preserved for 2 weeks at 4°C are less effective in ensuring normal oxygenation in the microcirculation than nonpreserved RBCs (17). Now, it is known that blood bankstored RBCs for transfusion are prone to various alterations (18); these involve the RBC membrane-skeleton and rheologic properties to an extent similar to the defects found in uremic patients' RBCs (19).…”

Section: Altered Composition Of the Erythrocyte Cell Membranementioning

confidence: 99%

Erythrocyte Alterations and Increased Cardiovascular Risk in Chronic Renal Failure

et al. 2017

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Patients suffering from chronic renal failure have a higher burden of cardiovascular events, which increases in a dose-dependent fashion as renal function worsens. Increased cardiovascular risk in these patients is thought to be mediated by the simultaneous presence of both traditional and non-traditional cardiovascular risk factors, the latter being associated with renal impairment. Red blood cells are usually considered as carries of nutrients for tissues and respiratory gases, less so as compartments essential to vascular integrity. However, erythrocyte number, size, and integrity seem to severely affect cardiovascular morbidity and mortality as established in recent clinical studies with large patient cohorts. In particular, the role of red blood cells in chronic renal failure tends only to be considered exclusively in relation to a change in their number. However, these cells in the uremic milieu are prone to many alterations, which may adversely affect the cardiovascular system. In this review, we highlight the main qualitative erythrocyte alterations that may have a pathophysiologic role in the elevated cardiovascular risk of chronic renal failure.

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“…However, studies of blood transfusions in acute respiratory distress syndrome (ARDS), sepsis, and trauma have not shown any improvement in oxygen uptake (53)(54)(55)(56). This may be due to partially reversible biochemical and structural changes in stored blood, collectively termed the RBC storage lesion, which may inhibit oxygen unloading, normal capillary flux, and tissue oxygenation (57,58), particularly in the first 12-24 hours after transfusion, as for example in the regeneration of 2,3-DPG (59).…”

Section: Management Of Anemia In Critical Illness Blood Transfusionsmentioning

confidence: 99%

Anemia in Critical Illness

Hayden

Albert

Watkins

et al. 2012

Am J Respir Crit Care Med

201

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Anemia is common in the intensive care unit, and may be associated with adverse consequences. However, current options for correcting anemia are not without problems and presently lack convincing efficacy for improving survival in critically ill patients. In this article we review normal red blood cell physiology; etiologies of anemia in the intensive care unit; its association with adverse outcomes; and the risks, benefits, and efficacy of various management strategies, including blood transfusion, erythropoietin, blood substitutes, iron therapy, and minimization of diagnostic phlebotomy.

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Effects of fresh versus banked blood transfusions on microcirculatory hemodynamics and tissue oxygenation in the rat cremaster model

Cited by 35 publications

References 21 publications

Impact of Red Blood Cell Transfusion on Global and Regional Measures of Oxygenation

Impact of Red Blood Cell Transfusion on Global and Regional Measures of Oxygenation

Erythrocyte Alterations and Increased Cardiovascular Risk in Chronic Renal Failure

Anemia in Critical Illness

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