Extracellular haemoglobin, oxidative stress and quality of red blood cells relative to perioperative blood salvage

Gueye, Papa; Bertrand, Françoise; Duportail, Guy; Lessinger, Jean‐Marc

doi:10.1515/cclm.2010.106

Cited by 16 publications

(13 citation statements)

References 31 publications

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“…Although numerous studies on the production and side effects of free Hb have been widely conducted, there are no definite criteria for the appropriate level of free Hb in reinfused salvaged blood [11,12,15]. Therefore, the acceptable level of free Hb in blood collected using an autotransfusion apparatus should be determined by investigating the severity of side effects according to the free Hb levels.…”

Section: Discussionmentioning

confidence: 99%

Suction conditions for minimizing the production of free hemoglobin during blood salvage using an autotransfusion apparatus

Choi

Ahn

2011

Korean J Anesthesiol

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BackgroundThree kinds of conditions should be considered to reduce free hemoglobin production using an autologous cell salvage device. They are the negative suction pressure, the size of suction tip, and the air contact during suction. We want to examine which condition is the most important factor to produce free hemoglobin.MethodsOne pack of red blood cell and one pack of fresh frozen plasma with the same blood type were mixed. They were aspirated based on the two suction pressure (-150 mmHg or -300 mmHg), three sizes of suction tips, and the two conditions of air contact, in which the suction tip was located in the surface of blood or in the middle of the blood. Seven ml sized EDTA tube was used to collect 5 ml blood. All the procedure repeated ten times. Free hemoglobin, total hemoglobin, and hematocrit were measured. Hemolysis ratio was calculated with following formula. Hemolysis ratio = (new free hemoglobin production) × (100-hematocrit) / (total hemoglobin).ResultsFree hemoglobin production and hemolysis ratio were increased when the suction tip was positioned in the surface than when it was in the middle of the blood. The pressure of negative suction and three kinds of the suction tips did not influence the production of free hemoglobin nor the hemolysis ratio.ConclusionsThe air contact is the most important factor to reduce hemolysis using autologous cell salvage device. Suction pressure or suction tip diameter have little influence to produce hemolysis.

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Section: Discussionmentioning

confidence: 99%

Suction conditions for minimizing the production of free hemoglobin during blood salvage using an autotransfusion apparatus

Choi

Ahn

2011

Korean J Anesthesiol

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“…Washing has been shown to improve the in vitro characteristics of stored RBCs. [4][5][6][7][8][9][10][14][15][16][17] Earlier generations of cells washers were labor intensive and considered "open systems," which limited the shelf life of washed cells to 24 hours. Current microprocessor-driven, closed-system cell-washers can be programmed to provide extensive cell washing and an approved shelf life of 14 days.…”

Section: Introductionmentioning

confidence: 99%

Washing older blood units before transfusion reduces plasma iron and improves outcomes in experimental canine pneumonia

Cortés‐Puch

Wang

Sun

et al. 2014

Blood

107

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• Washing older blood before transfusion reduces plasma iron, improving outcomes from established infection in canines.• In contrast, washing fresh blood before transfusion increases in vivo plasma CFH release, worsening outcomes.In a randomized controlled blinded trial, 2-year-old purpose-bred beagles (n 5 24), with Staphylococcus aureus pneumonia, were exchanged-transfused with either 7-or 42-dayold washed or unwashed canine universal donor blood (80 mL/kg in 4 divided doses). Washing red cells (RBC) before transfusion had a significantly different effect on canine survival, multiple organ injury, plasma iron, and cell-free hemoglobin (CFH) levels depending on the age of stored blood (all, P < .05 for interactions). Washing older units of blood improved survival rates, shock score, lung injury, cardiac performance and liver function, and reduced levels of non-transferrin bound iron and plasma labile iron. In contrast, washing fresh blood worsened all these same clinical parameters and increased CFH levels. Our data indicate that transfusion of fresh blood, which results in less hemolysis, CFH, and iron release, is less toxic than transfusion of older blood in critically ill infected subjects. However, washing older blood prevented elevations in plasma circulating iron and improved survival and multiple organ injury in animals with an established pulmonary infection. Our data suggest that fresh blood should not be washed routinely because, in a setting of established infection, washed RBC are prone to release CFH and result in worsened clinical outcomes. (Blood. 2014;123(9):1403-1411 IntroductionTransfusion of older stored canine universal donor blood in a canine model of experimental Staphylococcus aureus pneumonia results in markedly increased lung injury and mortality rates.1 Transfusion with older blood is also associated with increased levels of cell-free hemoglobin (CFH), transferrin bound iron (TBI), non-TBI (NTBI) and plasma labile iron (PLI). NTBI represents iron excess bound to proteins that do not normally handle circulating iron, and PLI is the toxic iron moiety in plasma. Whereas increased nitric oxide scavenging by CFH causing vasoconstriction and vascular injury and increased available iron promoting bacterial growth represent 2 candidate mechanisms of injury, multiple other biological changes have been documented with increasing blood storage interval.2,3 Some of these changes involve the release into the plasma of biologically active proteins, microvesicles, potassium, acid, and plasticizer, all of which can be reduced by means of standard red cell (RBC) washing procedures. [4][5][6][7][8][9][10] The clinical effect(s) of washing on the RBC storage lesion has not been studied.RBC washing has long been performed to reduce potassium levels in stored blood transfused to neonates, debris from RBCs recovered during surgery, cryoprotectant glycerol from cryopreserved RBCs, and plasma proteins from blood intended for patients who have been sensitized to those proteins.11-13 Automated cell washers cap...

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“…Des auteurs ont récemment rapporté que l'hémoglobine libre (extra-érythrocytaire) était susceptible d'entraîner des effets délétères sur le globule rouge en termes de stress oxydant pouvant provoquer une hyperhémolyse (Buehler et Alayash, 2004;Gueye et al, 2006 ;Gueye et al, 2010). L'haptoglobine constitue le premier mécanisme de défense de l'organisme contre les effets délétères de l'hémoglobine.…”

Section: Introductionunclassified

Aggravation de l’anémie et polymorphisme de l’haptoglobine au cours de la drépanocytose au Sénégal

Gueye

Fatou²,

Seck³

et al. 2014

Int. J. Bio. Chem. Sci

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Extracellular haemoglobin, oxidative stress and quality of red blood cells relative to perioperative blood salvage

Abstract: Haemolysis must be limited during perioperative blood salvage in order to prevent exposure to oxidative stress and improve the efficiency of autotransfusion.

Cited by 16 publications

References 31 publications

Suction conditions for minimizing the production of free hemoglobin during blood salvage using an autotransfusion apparatus

Suction conditions for minimizing the production of free hemoglobin during blood salvage using an autotransfusion apparatus

Washing older blood units before transfusion reduces plasma iron and improves outcomes in experimental canine pneumonia

Aggravation de l’anémie et polymorphisme de l’haptoglobine au cours de la drépanocytose au Sénégal

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