The effect of the transfusion of stored RBCs on intestinal microvascular oxygenation in the rat

Bommel, Jasper van; Korte, Dirk de; Lind, A.; Siegemund, Martin; Trouwborst, A.; Verhoeven, Arthur J.; İnce, Can; Henny, C. P.

doi:10.1046/j.1537-2995.2001.41121515.x

Cited by 100 publications

(69 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We measured RBC deformability using the laser-assisted optical rotational cell analyzer (LORCA) assay, in which RBCs are subjected to increasing shear stress over several minutes (45,46). Our prespecified major shear stress of interest was 3 Pa, a level that may be encountered in the microcirculation of humans (47)(48)(49). Deformability also decreased significantly over the 42-day storage period at 30 Pa, suggesting that the membrane defect induced by storage is pronounced enough to moderately resist the ability to deform even at a very high level of shear stress.…”

Section: H) P Values Represent Comparison Between Values In Rbcs Assmentioning

confidence: 99%

Evolution of adverse changes in stored RBCs

Bennett‐Guerrero¹,

Veldman²,

Doctor

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

545

556

View full text Add to dashboard Cite

Recent studies have underscored questions about the balance of risk and benefit of RBC transfusion. A better understanding of the nature and timing of molecular and functional changes in stored RBCs may provide strategies to improve the balance of benefit and risk of RBC transfusion. We analyzed changes occurring during RBC storage focusing on RBC deformability, RBC-dependent vasoregulatory function, and S-nitrosohemoglobin (SNO-Hb), through which hemoglobin (Hb) O2 desaturation is coupled to regional increases in blood flow in vivo (hypoxic vasodilation). Five hundred ml of blood from each of 15 healthy volunteers was processed into leukofiltered, additive solution 3-exposed RBCs and stored at 1-6°C according to AABB standards. Blood was subjected to 26 assays at 0, 3, 8, 24 and 96 h, and at 1, 2, 3, 4, and 6 weeks. RBC SNO-Hb decreased rapidly (1.2 ؋ 10 ؊4 at 3 h vs. 6.5 ؋ 10 ؊4 (fresh) mol S-nitrosothiol (SNO)/mol Hb tetramer (P ‫؍‬ 0.032, mercuric-displaced photolysis-chemiluminescence assay), and remained low over the 42-day period. The decline was corroborated by using the carbon monoxide-saturated copper-cysteine assay [3.0 ؋ 10 ؊5 at 3 h vs. 9.0 ؋ 10 ؊5 (fresh) mol SNO/mol Hb]. In parallel, vasodilation by stored RBCs was significantly depressed. RBC deformability assayed at a physiological shear stress decreased gradually over the 42-day period (P < 0.001). Time courses vary for several storage-induced defects that might account for recent observations linking blood transfusion with adverse outcomes. Of clinical concern is that SNO levels, and their physiological correlate, RBC-dependent vasodilation, become depressed soon after collection, suggesting that even ''fresh'' blood may have developed adverse biological characteristics.adenosine triphosphate ͉ hemoglobin ͉ nitric oxide ͉ S-nitrosothiols ͉ transfusion

show abstract

Section: H) P Values Represent Comparison Between Values In Rbcs Assmentioning

confidence: 99%

Evolution of adverse changes in stored RBCs

Bennett‐Guerrero¹,

Veldman²,

Doctor

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

545

556

View full text Add to dashboard Cite

show abstract

“…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

202

View full text Add to dashboard Cite

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.

show abstract

“…Red blood cells which stored for a period of time (28 days or longer) in the blood bank do not perform as fresh as fresh blood. They are fragile, nondistensible, depleted of 2, 3 diphosphoglycerate (DPG) and have a dramatically left-shifted oxy-hemoglobin dissociation curve [22,23]. Because the oxy-hemoglobin curve is so left-shifted in stored blood, it is attainable that bank blood may actually draw oxygen out of the tissues or microcirculation.…”

Section: Discussionmentioning

confidence: 99%

Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery

et al. 2009

View full text Add to dashboard Cite

AbstractTransfusion after cardiac surgery is very common. This rate varies between institutions and has remained high despite established transfusion guidelines. We analyzed our database of patients who underwent isolated CABG (Coronary Artery Bypass Graft) to determine the predictive factors of homologous transfusion and associated postoperative morbidity, mortality and resource utilization. All 14,152 patients who underwent first-time isolated CABG, with or without cardiopulmonary bypass (CPB) who had postoperative homologous transfusion between February 2002 and March 2008 in Tehran Heart Center, were evaluated retrospectively. Overall, 16.5% of patients received transfusion. Transfused patients demonstrated a significantly higher incidence of postoperative complications (cardiac, infectious, ischemic, reoperation) and mortality (p<0.001). Homologous blood transfusion effect on mortality, morbidity and resource utilization. By Multivariable logistic regression analysis adjusted for confounders: Homologous blood transfusion effect on Mortality (30-days) (OR=3.976, p<0.0001), Prolonged ventilation hours (OR=4.755, p<0.0001), Total ICU hours (β =14.599, p<0.0001), Hospital length of stay (β =1.141, p<0.0001), Post surgery length of stay (β =0.955, p<0.0001). We conclude that the isolated CABG patients receiving blood transfusion have significantly higher mortality, morbidity and resource utilization. Homologous blood transfusion is an independent factor of increased resource utilization, morbidity and mortality.

show abstract

The effect of the transfusion of stored RBCs on intestinal microvascular oxygenation in the rat

Cited by 100 publications

References 45 publications

Evolution of adverse changes in stored RBCs

Evolution of adverse changes in stored RBCs

Anemia in Critical Illness

Transfusion associated in-hospital mortality and morbidity in isolated Coronary Artery Bypass Graft surgery

Contact Info

Product

Resources

About