Temporal changes in hematologic markers after splenectomy, splenic embolization, and observation for trauma

Wernick, Brian; Cipriano, Anthony; Odom, Stephen R.; MacBean, Ulunna; Mubang, Ronnie; Wojda, Thomas R; Liu, S.; Serres, S.; Evans, David C.; Thomas, Pete; Cook, Charles H.; Stawicki, Stanislaw P

doi:10.1007/s00068-016-0679-0

Cited by 18 publications

(12 citation statements)

References 33 publications

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“…Any of these organs may have been a source of platelets in the splenectomized animals in our study. Under certain conditions, splenectomy in humans can result in a greater red cell distribution width (36). In our current experiments, however, pre-exposure red cell distribution width was lower in splenectomized animals than in sham animals.…”

Section: Discussioncontrasting

confidence: 69%

Increased Hematocrit Due to Electrical‐Waveform Exposures in Splenectomized Sus scrofa,

Jauchem

Burns

Voorhees

et al. 2018

Journal of Forensic Sciences

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In laboratory studies of the pig Sus scrofa, hematocrit has consistently increased after conducted‐electrical‐weapon (CEW) exposures, possibly due to contraction of the spleen. Splenectomized animals and intact sham control animals were exposed, each for 30 sec, to a benchtop‐produced electrical waveform of net charge levels similar to those of some CEWs. Changes in the blood were compared statistically. Hematocrit increased significantly in both splenectomized and sham animals. There were no significant main‐effect differences between values of hematocrit from the two groups. There were, however, significant interactive effects of time and splenectomy for hematocrit, red blood cell count, and hemoglobin. After peak values were reached for these variables, values returned toward baseline levels more slowly in splenectomized animals. This may have been due to the lack of a spleen to sequester red blood cells (thereby resulting in more cells remaining in the general circulation), unlike sham animals with intact spleens.

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Section: Discussioncontrasting

confidence: 69%

Increased Hematocrit Due to Electrical‐Waveform Exposures in Splenectomized Sus scrofa,

Jauchem

Burns

Voorhees

et al. 2018

Journal of Forensic Sciences

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“…This emphasizes the importance of establishing the functionality of the spleen, especially in the study of diabetic control ( Willekens et al, 2003 ). Also, the notable paucity of data for microvesicles generated in vivo warrants a more detailed investigation on the fundamental and clinical relationship between splenectomy or functional asplenia, RBC-derived microvesicles and RBC homeostasis ( Wernick et al, 2017 ).…”

Section: The Role Of the Spleenmentioning

confidence: 99%

Red Blood Cell Homeostasis: Mechanisms and Effects of Microvesicle Generation in Health and Disease

2018

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Red blood cells (RBCs) generate microvesicles to remove damaged cell constituents such as oxidized hemoglobin and damaged membrane constituents, and thereby prolong their lifespan. Damage to hemoglobin, in combination with altered phosphorylation of membrane proteins such as band 3, lead to a weakening of the binding between the lipid bilayer and the cytoskeleton, and thereby to membrane budding and microparticle shedding. Microvesicle generation is disturbed in patients with RBC-centered diseases, such as sickle cell disease, glucose 6-phosphate dehydrogenase deficiency, spherocytosis or malaria. A disturbance of the membrane-cytoskeleton interaction is likely to be the main underlying mechanism, as is supported by data obtained from RBCs stored in blood bank conditions. A detailed proteomic, lipidomic and immunogenic comparison of microvesicles derived from different sources is essential in the identification of the processes that trigger vesicle generation. The contribution of RBC-derived microvesicles to inflammation, thrombosis and autoimmune reactions emphasizes the need for a better understanding of the mechanisms and consequences of microvesicle generation.

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“…20 Many authors showed its prognostic value in essentially distinct conditions. [21][22][23][24][25][26][27][28][29][30] In 2017, Lippi et al demonstrated that among all trauma patients, RDW-CV > 14.6% is indicative of TBI. 31 In our study, RDW-CV correlated with age (p < 0.05; R ¼ 0.175) and was associated with higher mortality (p ¼ 0.044).…”

Section: Discussionmentioning

confidence: 99%

Predicting Outcome and Conservative Treatment Failure in Patients with Skull Fracture after Traumatic Brain Injury: A Retrospective Cohort Study

Bobeff

Posmyk

Bobeff

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Objective Traumatic brain injury (TBI) remains a major cause of morbidity and mortality worldwide. The prognostic value of skull fracture (SF) remains to be clearly defined. To evaluate the need for neurosurgical intervention and determine the risk factors of conservative treatment failure (CTF), we retrieved from the hospital database the records of patients with SF after TBI. Methods We analyzed 146 consecutive patients (mean age: 49.8 ± 17.5 years) treated at the department of neurosurgery in a 5-year period. Clinical data, radiologic reports, and laboratory results were evaluated retrospectively. Results A total of 63% of patients were treated conservatively, 21.9% were operated on immediately, and 15.1% experienced CTF. Overall, 73.3% had a favorable outcome; the mortality rate was 13%. Intracranial bleeding occurred in 96.6% of cases, basilar SF in 61%, and cerebrospinal fluid (CSF) leak in 2.8%. The independent risk factors for outcome were Glasgow Coma Scale (GCS) score, age, and platelet count (PCT). The independent risk factors for CTF were epidural hematoma, subdural hematoma, mass effect, edema, international normalized ratio, PCT, mean platelet volume, and CSF leakage. The consensus decision tree algorithm used at the accident and emergency department indicated patients with no need for neurosurgical intervention with an accuracy of 91.7%, sensitivity of 88.9%, and featured the importance of mass effect, GCS, and epidural hematoma. Conclusions Tests included in the complete blood count appeared useful for predicting the course in patients with SF, although the most important factors were age and neurologic status, as well as radiologic findings. Our decision tree requires further validation before it can be used in everyday practice.

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Temporal changes in hematologic markers after splenectomy, splenic embolization, and observation for trauma

Cited by 18 publications

References 33 publications

Increased Hematocrit Due to Electrical‐Waveform Exposures in Splenectomized Sus scrofa,

Increased Hematocrit Due to Electrical‐Waveform Exposures in Splenectomized Sus scrofa,

Red Blood Cell Homeostasis: Mechanisms and Effects of Microvesicle Generation in Health and Disease

Predicting Outcome and Conservative Treatment Failure in Patients with Skull Fracture after Traumatic Brain Injury: A Retrospective Cohort Study

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