Red Blood Cell Sublethal Damage: Hemocompatibility Is not the Absence of Hemolysis

McNamee, Antony P.; Simmonds, Michael J.

doi:10.1016/j.tmrv.2023.03.001

Cited by 3 publications

(3 citation statements)

References 87 publications

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“…After weaning from CPB, groups without NO showed a significant decrease in CMPLI and CPPLI, which indicates a deterioration in erythrocyte deformability after CPB. [ 10 11 ] In the groups with NO, the same variables remained in the same range before and after CPB. This indicates the positive effect of NO on stabilising the structural organisation of protein-lipid interactions of erythrocyte membranes and maintaining better erythrocyte deformability.…”

Section: Discussionmentioning

confidence: 80%

“…[ 6 ] Other studies on i-FABP have already shown that during haemolysis, the release of free haemoglobin causes intravascular NO absorption, which leads to impaired organ perfusion with subsequent tissue injury and increased i-FABP levels. [ 7 8 9 10 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…The damaged lipid and protein components lead to impaired erythrocyte deformability, a decrease in its ability to penetrate small capillaries and diffuse gases and, consequently, tissue hypoxia. [ 10 11 14 ] It is possible that NO, under increased oxidative stress during CPB, CA, and hypothermia, can prevent the active formation of reactive oxygen species and lipid peroxidation and, consequently, reduce damage to membrane structures by free radicals. [ 12 13 17 ]…”

Section: Discussionmentioning

confidence: 99%

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Effect of inhaled nitric oxide on intestinal integrity in cardiopulmonary bypass and circulatory arrest simulation: An experimental study

Kamenshchikov,

Churilina,

Korepanov

et al. 2024

Indian Journal of Anaesthesia

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Background and Aims: Cardiopulmonary bypass (CPB) and circulatory arrest (CA) can induce intestinal injury and consequently lead to multiple organ dysfunction. Nitric oxide (NO) has protective effects, but its effect on the intestine has not been studied. The study aimed to investigate intestinal injury variables and prove the intestinal protective effects of exogenous nitric oxide when modelling CPB and CA in an experiment. Methods: The study was performed on sheep (n = 24). There were four groups: CPB, CPB + NO, CPB + CA and CPB + CA + NO. Sheep in NO groups received intraoperative inhalation of NO at a dose of 80 ppm. Groups without NO underwent CPB and CA without NO delivery. Defaecation rate, dynamics of intestinal fatty acid binding protein (i-FABP), coefficient of microviscosity and polarity in the areas of lipid–lipid and protein-lipid interactions of erythrocyte membranes were assessed. One hour after CPB, the intestinal tissue was collected and assessed for tissue concentrations of adenosine triphosphate (ATP) and lactate. Results: The defaecation rate after CPB was higher in the CPB + NO group than in the CPB group. The concentration of i-FABP after CPB was lower in the CPB + NO and CPB + CA + NO groups than in the CPB and CPB + CA groups. Erythrocyte deformability before and after CPB revealed no significant dynamics in groups with NO. The ATP concentration 1 h after CPB was higher in the CPB + NO group than in the CPB group. The morphological picture in groups with NO was better. Conclusion: When modelling CPB and CA, NO had a positive effect on the functional and structural state of the intestine and also maintained erythrocyte deformability.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of inhaled nitric oxide on intestinal integrity in cardiopulmonary bypass and circulatory arrest simulation: An experimental study

Kamenshchikov,

Churilina,

Korepanov

et al. 2024

Indian Journal of Anaesthesia

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Perspective: Will blood-informed design signal the fourth generation of cardiac assist devices?

Simmonds,

Thamsen,

Olia

et al. 2024

The Journal of Heart and Lung Transplantation

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Unbiased Morphometric Assessment of Red Blood Cell Storage Lesion in the Presence of Shear-Induced Stomatocytes

Boecker,

Halblaub Miranda,

Klüter

et al. 2024

Transfus Med Hemother

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Introduction: Red blood cells (RBCs) undergo progressive biochemical and morphological changes during storage, collectively called storage lesion. The quality of red cell concentrates (RCCs) is typically assessed by quantifying hemolysis. An assessment of morphological changes, associated with low quality RBCs, could give an additional indication of the safety and efficacy of the concentrates. The current standard for determining morphological changes is a manual, laborious, and subjectively biased microscopic process that limits the number of cells that can be examined. When using alternative methods like flow cells, flow and shear-induced morphologies affecting especially stomatocyte morphologies must be taken into account. We already established an automated flow morphometric RBC analysis system as an alternative to manual microscopic evaluation. The goal of the present work is to obtain a robust, automated, morphology-related signal (lesion index) quantifying RBC storage lesion in a laminar flow channel under conditions similar to stasis that is not affected by shear-induced reversible morphology changes. Methods: We use a convolutional neural network (CNN) for high throughput classification of RBCs. We analyzed the morphological changes of 5 RCCs over a period of 12 weeks and classified RBC morphologies, including such that are degradation-induced and reversible. We introduce a lesion index to denote the percentage of irreversible spherical morphologies, known to reduce the post-transfusion survival of erythrocytes. We further addressed shear-induced stomatocyte morphologies in laminar flow and whether these affect CNN-based RBC classification. Results: Our flow morphometry system achieves a high-resolution classification comprising nine morphological classes with an excellent overall accuracy of 92% and F1 scores between 84% and 97%. We generate strong evidence that the morphological lesion index can predict the hemolysis level in RCCs during storage. The power of this new classification technique allowed it, for the first time, to detect and measure the lateral concentration gradient of stomatocytes in a conventional flow chamber. Importantly, we show that reversible shear rate-induced morphologies, typical for microfluidic systems, bear no influence on the lesion index. Conclusion: Flow morphometry combined with evaluation by a CNN allows to reliably assess RBC storage lesion and thus concentrate quality. Additionally, this method reduces the need for complex laboratory procedures.

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Red Blood Cell Sublethal Damage: Hemocompatibility Is not the Absence of Hemolysis

Cited by 3 publications

References 87 publications

Effect of inhaled nitric oxide on intestinal integrity in cardiopulmonary bypass and circulatory arrest simulation: An experimental study

Effect of inhaled nitric oxide on intestinal integrity in cardiopulmonary bypass and circulatory arrest simulation: An experimental study

Perspective: Will blood-informed design signal the fourth generation of cardiac assist devices?

Unbiased Morphometric Assessment of Red Blood Cell Storage Lesion in the Presence of Shear-Induced Stomatocytes

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