Symposium on fresh whole blood for severe hemorrhagic shock: From in-hospital to far forward resuscitations

Spinella, Philip C.; Strandenes, Geir; Rein, Erling Bekkestad; Seghatchian, Jerard; Hervig, Tor

doi:10.1016/j.transci.2012.01.002

Cited by 28 publications

(23 citation statements)

References 11 publications

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“…Recently an increasing interest and research on whole blood resuscitation has emerged [44]. The use of fresh warm whole blood in battle grounds has been proved to improve mortality and hemostasis [45].…”

Section: Discussionmentioning

confidence: 99%

Albumin-induced coagulopathy is less severe and more effectively reversed with fibrinogen concentrate than is synthetic colloid-induced coagulopathy

Winstedt

Hanna

Schött

2013

Scandinavian Journal of Clinical and Laboratory Investigation

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Introduction Autophagy is well known as one of the biogenic responses against various stresses, which possesses the benefi cial roles for survival, but little is known about the dynamics and its signifi cance during the septic condition. We hypothesized that autophagy is induced during the septic condition, and contributes to protect from tissue damage which subsequently leads to organ dysfunction. We confi rm whether the autophagic process is accelerated or sustained in an acute phase of sepsis and we also determine its physiological role. Methods Sepsis was induced by cecal ligation and puncture (CLP) in mice. We examined the kinetics of autophagosome and auto lysosome formation which may explain the status of autophagy by western blotting, immunohistochemistry, and electron microscopy. To investigate a precise role of autophagy in CLP-induced sepsis, chloroquine, an autophagy inhibitor, was administered to the CLP-operated mice, and blood chemistry, pathology of the liver and survival were evaluated. Results Autophagy demonstrated by the ratio of LC3-II/LC3-I was induced over the time course up to 24 hours after CLP. The ratio was particularly increased in the liver, heart and spleen. Autophagosome formation became maximal at 6 hours and declined by 24 hours after CLP. Autolysosome formation as evaluated by both fusion of GFP-LC3 dots with LAMP1 immunohistochemistry and electron microscopy was also increased after the procedure. Furthermore, inhibition of autophagy by chloroquine during the CLP procedure resulted in elevation of serum AST levels, and signifi cantly increased mortality in mice. Conclusion Autophagy was induced in several organs over the time course of the CLP sepsis model and then the process was gradually completed to degradation of the components. Our data suggest autophagy plays a protective role in organ dysfunction in sepsis. P2Reversible depressive eff ect of TNFα on a model of isolated perfused rat heart BV Nguyen Introduction Acute myocardial depression in septic shock is common [1]. Myocardial depression is mediated by circulating depressant substances, which until now have been incompletely characterized [2].The aim of our study was to observe the eff ects of TNFα on the model of perfused rat heart. Methods After profound anesthesia with pentothal, the Wistar rats were killed by exsanguination. After sternotomy, the heart was taken and connected to the Langendorf column. The apex of the heart was hooked to a strength sensor. Biopac student laboratory software was used to record and analyse heart contractions. Contractions were recorded every 5 minutes during periods of 20 minutes. Control measurements were fi rst recorded. We measured four parameters: heart rate, contraction force, speeds of contraction and relaxation for control, during TNFα (20 ng/ml) exposure and after removal of TNFα. We express the variations of parameters as percentage of the control ± SEM. A paired t test was used to compare heart rate, contraction amplitude, speeds of contraction and relaxation with TNFα and ...

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Section: Discussionmentioning

confidence: 99%

Albumin-induced coagulopathy is less severe and more effectively reversed with fibrinogen concentrate than is synthetic colloid-induced coagulopathy

Winstedt

Hanna

Schött

2013

Scandinavian Journal of Clinical and Laboratory Investigation

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“…Studies have compared the effects of storage in RBCs <7 d old with RBCs stored for 7–30 d, but these studies used RBCs processed with conventional blood bank protocols [6–8]. Military use of warm fresh whole blood for transfusion has been associated with increased efficacy and decreased RBC storage lesions [9]. Murine studies indicate that fresh blood may abrogate some of the negative immune effects seen with stored RBCs, but fresh blood as a model has not been applied to human cells [6,10].…”

Section: Introductionmentioning

confidence: 99%

Immunologic profiles of red blood cells using in vitro models of transfusion

Long

Meier

Ward

et al. 2013

Journal of Surgical Research

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Background Transfusion of packed red blood cells (RBCs) produces a myriad of immunologic derangements, from suppressive to stimulatory. Proliferation of human T cells is suppressed in vitro after exposure to processed red blood cells (PRBCs). We hypothesized that this effect would be mitigated by using fresh RBCs. We also hypothesized that this suppressive effect was a generalized effect on lymphocyte proliferation and would be observed in both CD4+ and CD8+ T-cell subpopulations as well as B cells. Materials and methods We isolated human T cells from donor peripheral blood mononuclear cells and exposed them to either blood bank PRBCs or fresh RBCs from volunteer donors and stimulated them with anti-CD3/anti-CD28. Human B cells were stimulated with lipopolysaccharide and exposed to PRBCs or fresh RBCs. We measured proliferation of B cells by thymidine incorporation assays. We also treated RBCs with citrate-phosphate-dextrose (CPD) at different time points before culture them with stimulated T cells to determine the role of this common RBC storage solution in lymphocyte proliferation. Results In vitro proliferation of CD4+ and CD8+ T cells was suppressed by blood bank RBCs. This suppression is eliminated when fresh RBCs were used. The B cells showed inhibition of proliferation when exposed to similar conditions, which appeared to be consistent over serial dilutions. Fresh RBCs exposed to CPD did not appear suppressive in the first 6 h after exposure. Conclusions T-cell and B-cell proliferation inhibition by blood banked RBCs suggests a generalized effect of RBCs on cellular proliferation. The lack of suppression by fresh RBCs further suggests that something involved in blood banking alters RBC properties such that they attain a suppressive phenotype. One such blood banking component, CPD, does not appear to affect this suppressive phenotype within the first 6 h.

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“…5 Other North Atlantic Treaty Org an ization (NATO) countries, such as Norway, have developed an aggressive research and training program pertaining to FWB in Special Operations settings and have created a program called Blood Far Forward (BFF) to look at aspects of this practice. 6,7 In particular, the Norwegian group has created a training program and protocol for collection and administration of FWB by Special Operations Forces medics. 7 …”

Section: Fresh Whole Blood and Special Operations Forcesmentioning

confidence: 99%

“…Also, there are biological advantages to FWB transfusions: FWB has been reported to have increased clotting factor activity and is already warm, thereby making fluid warmers unnecessary. 6,7 Finally, FWB is a source of fresh platelets; platelets are otherwise difficult, if not impossible, to transport and use in the far forward environment. 6 …”

Section: Benefits Of Fwb In Special Operations Environmentsmentioning

confidence: 99%

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Fresh whole blood transfusion capability for Special Operations Forces

et al. 2015

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Fresh whole blood (FWB) transfusion is an option for providing volume and oxygen carrying capacity to bleeding Special Operations soldiers who are injured in an austere environment and who are far from a regular blood bank. Retrospective data from recent conflicts in Iraq and Afghanistan show an association between the use of FWB and survival. We reviewed the literature to document the issues surrounding FWB transfusion to Special Operations soldiers in the austere en vironment and surveyed the literature regarding best practice guidelines for and patient outcomes after FWB transfusions. Most literature regarding FWB transfusion is retrospective or historical. There is limited prospective evidence currently to change transfusion practice in tertiary care facilities, but FWB remains an option in the austere setting.

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Symposium on fresh whole blood for severe hemorrhagic shock: From in-hospital to far forward resuscitations

Cited by 28 publications

References 11 publications

Albumin-induced coagulopathy is less severe and more effectively reversed with fibrinogen concentrate than is synthetic colloid-induced coagulopathy

Albumin-induced coagulopathy is less severe and more effectively reversed with fibrinogen concentrate than is synthetic colloid-induced coagulopathy

Immunologic profiles of red blood cells using in vitro models of transfusion

Fresh whole blood transfusion capability for Special Operations Forces

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