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Blood Transfusion = Trasfusione Del... Mar 2017
Topics: Blood Preservation; Clinical Trials as Topic; Erythrocyte Aging; Erythrocyte Transfusion; Erythrocytes; Humans
PubMed: 28263164
DOI: 10.2450/2017.0018-17 -
British Journal of Anaesthesia Oct 2010The use of intraoperative cell salvage and autologous blood transfusion has become an important method of blood conservation. The main aim of autologous transfusion is... (Review)
Review
The use of intraoperative cell salvage and autologous blood transfusion has become an important method of blood conservation. The main aim of autologous transfusion is to reduce the need for allogeneic blood transfusion and its associated complications. Allogeneic blood transfusion has been associated with increased risk of tumour recurrence, postoperative infection, acute lung injury, perioperative myocardial infarction, postoperative low-output cardiac failure, and increased mortality. We have reviewed the current evidence for cell salvage in modern surgical practice and examined the controversial issues, such as the use of cell salvage in obstetrics, and in patients with malignancy, or intra-abdominal or systemic sepsis. Cell salvage has been demonstrated to be safe and effective at reducing allogeneic blood transfusion requirements in adult elective surgery, with stronger evidence in cardiac and orthopaedic surgery. Prolonged use of cell salvage with large-volume autotransfusion may be associated with dilution of clotting factors and thrombocytopenia, and regular laboratory or near-patient monitoring is required, along with appropriate blood product use. Cell salvage should be considered in all cases where significant blood loss (>1000 ml) is expected or possible, where patients refuse allogeneic blood products or they are anaemic. The use of cell salvage in combination with a leucocyte depletion filter appears to be safe in obstetrics and cases of malignancy; however, further trials are required before definitive guidance may be provided. The only absolute contraindication to the use of cell salvage and autologous blood transfusion is patient refusal.
Topics: Blood Loss, Surgical; Blood Preservation; Blood Transfusion, Autologous; Humans; Intraoperative Care; Neoplasms; Postpartum Hemorrhage; Tissue and Organ Harvesting; Transfusion Reaction
PubMed: 20802228
DOI: 10.1093/bja/aeq244 -
Revista Brasileira de Cirurgia... 2014Allogeneic blood is an exhaustible therapeutic resource. New evidence indicates that blood consumption is excessive and that donations have decreased, resulting in... (Review)
Review
INTRODUCTION
Allogeneic blood is an exhaustible therapeutic resource. New evidence indicates that blood consumption is excessive and that donations have decreased, resulting in reduced blood supplies worldwide. Blood transfusions are associated with increased morbidity and mortality, as well as higher hospital costs. This makes it necessary to seek out new treatment options. Such options exist but are still virtually unknown and are rarely utilized.
OBJECTIVE
To gather and describe in a systematic, objective, and practical way all clinical and surgical strategies as effective therapeutic options to minimize or avoid allogeneic blood transfusions and their adverse effects in surgical cardiac patients.
METHODS
A bibliographic search was conducted using the MeSH term "Blood Transfusion" and the terms "Cardiac Surgery" and "Blood Management." Studies with titles not directly related to this research or that did not contain information related to it in their abstracts as well as older studies reporting on the same strategies were not included.
RESULTS
Treating anemia and thrombocytopenia, suspending anticoagulants and antiplatelet agents, reducing routine phlebotomies, utilizing less traumatic surgical techniques with moderate hypothermia and hypotension, meticulous hemostasis, use of topical and systemic hemostatic agents, acute normovolemic hemodilution, cell salvage, anemia tolerance (supplementary oxygen and normothermia), as well as various other therapeutic options have proved to be effective strategies for reducing allogeneic blood transfusions.
CONCLUSION
There are a number of clinical and surgical strategies that can be used to optimize erythrocyte mass and coagulation status, minimize blood loss, and improve anemia tolerance. In order to decrease the consumption of blood components, diminish morbidity and mortality, and reduce hospital costs, these treatment strategies should be incorporated into medical practice worldwide.
Topics: Blood Loss, Surgical; Blood Preservation; Blood Transfusion; Cardiac Surgical Procedures; Hemostatics; Humans; Medical Illustration; Operative Blood Salvage; Transfusion Reaction
PubMed: 25714216
DOI: 10.5935/1678-9741.20140114 -
Journal of Clinical Pathology May 2003To investigate the relation between ambient temperature and serum potassium concentrations in samples from primary care.
AIMS
To investigate the relation between ambient temperature and serum potassium concentrations in samples from primary care.
METHODS
Potassium concentrations were estimated on general practitioner and hospital ward samples taken over a two year period using serum obtained from gel separator samples. The number of samples analysed from general practice during each month varied from 5093 to 8978 (mean of 7068 samples/month).
RESULTS
As the temperature fell in winter, the mean daily serum potassium concentration rose in samples from general practice, with the inverse occurring during the warmer summer months. This effect was restricted to samples coming from general practice, with inpatient samples seemingly unaffected.
CONCLUSIONS
These results indicate that exposure of the samples to variations in ambient temperature during their transport to the laboratory profoundly affects measured serum potassium concentrations.
Topics: Blood Preservation; Blood Specimen Collection; False Positive Reactions; Family Practice; Humans; Hyperkalemia; Potassium; Seasons; Specimen Handling; Temperature
PubMed: 12719461
DOI: 10.1136/jcp.56.5.385 -
British Journal of Haematology Sep 2019Pathogen reduction technologies (PRTs) have been developed to further reduce the current very low risks of acquiring transfusion-transmitted infections and promptly... (Review)
Review
Pathogen reduction technologies (PRTs) have been developed to further reduce the current very low risks of acquiring transfusion-transmitted infections and promptly respond to emerging infectious threats. An entire portfolio of PRTs suitable for all blood components is not available, but the field is steadily progressing. While PRTs for plasma have been used for many years, PRTs for platelets, red blood cells (RBC) and whole blood (WB) were developed more slowly, due to difficulties in preserving cell functions during storage. Two commercial platelet PRTs use ultra violet (UV) A and UVB light in the presence of amotosalen or riboflavin to inactivate pathogens' nucleic acids, while a third experimental PRT uses UVC light only. Two PRTs for WB and RBC have been tested in experimental clinical trials with storage limited to 21 or 35 days, due to unacceptably high RBC storage lesion beyond these time limits. This review summarizes pre-clinical investigations and selected outcomes from clinical trials using the above PRTs. Further studies are warranted to decrease cell storage lesions after PRT treatment and to test PRTs in different medical and surgical conditions. Affordability remains a major administrative obstacle to PRT use, particularly so in geographical regions with higher risks of transfusion-transmissible infections.
Topics: Blood Platelets; Blood Preservation; Erythrocytes; Humans
PubMed: 31304588
DOI: 10.1111/bjh.16093 -
Journal of Veterinary Internal Medicine May 2019Development of equine platelet concentrate (PC) would aid management of cases requiring transfused platelets (PLTs), where adminstration of whole-blood or platelet-rich...
BACKGROUND
Development of equine platelet concentrate (PC) would aid management of cases requiring transfused platelets (PLTs), where adminstration of whole-blood or platelet-rich plasma (PRP) might be contraindicated.
OBJECTIVES
To test and validate a method for production of an equine PRP-PC product.
ANIMALS
Six healthy Thoroughbred geldings from a research herd.
METHODS
In this prospective experimental study, whole blood was collected and processed through multiple centrifugation steps to yield 120 mL of PC. The PC was stored at 22°C and gently and continuously agitated. Measurements of PLT count, pH, and concentrations of glucose, lactate, electrolytes, lactate dehydrogenase (LDH), and aspartate aminotransferase (AST), as well as partial pressures of oxygen and carbon dioxide were performed on days 0, 1, 2, 3, 5, and 7. Platelet aggregometry and bacterial culture were also performed.
RESULTS
The PC always had a PLT count of ≥550 × 10 cells/μL. Aggregometry graph amplitude (P < .0001) and area under the curve (P < .05) significantly decreased over time. Sodium, chloride, lactate (P < .0001), and oxygen (P < .01) concentrations significantly increased over time. pH (P < .001), glucose and bicarbonate concentrations (P < .0001) significantly decreased over time. There was no significant difference in potassium concentration, PLT count, LDH and AST activities and no bacterial growth from culture.
CONCLUSIONS AND CLINICAL IMPORTANCE
The described technique yielded a PC that meets the standards of the American Association of Blood Banks for human PC.
Topics: Animals; Blood Platelets; Blood Preservation; Centrifugation; Hematology; Horses; Male; Platelet Count; Platelet-Rich Plasma; Prospective Studies
PubMed: 30868640
DOI: 10.1111/jvim.15472 -
Blood Transfusion = Trasfusione Del... Mar 2017The advent of preservative solutions permitted refrigerated storage of red blood cells. However, the convenience of having red blood cell inventories was accompanied by... (Review)
Review
The advent of preservative solutions permitted refrigerated storage of red blood cells. However, the convenience of having red blood cell inventories was accompanied by a disadvantage. Red cells undergo numerous physical and metabolic changes during cold storage, the "storage lesion(s)". Whereas controlled clinical trials have not confirmed the clinical importance of such changes, ethical and operational issues have prevented careful study of the oldest stored red blood cells. Suggestions of toxicity from meta-analyses motivated us to develop pre-clinical canine models to compare the freshest vs the oldest red blood cells. Our model of canine pneumonia with red blood cell transfusion indicated that the oldest red blood cells increased mortality, that the severity of pneumonia is important, but that the dose of transfused red blood cells is not. Washing the oldest red blood cells reduces mortality by removing senescent cells and remnants, whereas washing fresher cells increases mortality by damaging the red blood cell membrane. An opposite effect was found in a model of haemorrhagic shock with reperfusion injury. Physiological studies indicate that release of iron from old cells is a primary mechanism of toxicity during infection, whereas scavenging of cell-free haemoglobin may be beneficial during reperfusion injury. Intravenous iron appears to have toxicity equivalent to old red blood cells in the pneumonia model, suggesting that intravenous iron and old red blood cells should be administered with caution to infected patients.
Topics: Animals; Blood Preservation; Disease Models, Animal; Dogs; Erythrocyte Transfusion; Erythrocytes; Female; Humans; Male; Pneumonia
PubMed: 28263166
DOI: 10.2450/2017.0306-16 -
Transfusion and Apheresis Science :... Oct 2021In 2014-2015, the Luxembourg Red Cross (LRC) implemented a fully automated system (FAS) able to process 4 whole blood units simultaneously, and a pathogen reduction...
In 2014-2015, the Luxembourg Red Cross (LRC) implemented a fully automated system (FAS) able to process 4 whole blood units simultaneously, and a pathogen reduction technology (PRT) based on riboflavin and ultraviolet light to improve safety of platelet concentrates (PCs). In this observational study, the impact of both technologies to enable this centralised blood transfusion centre to provide safe and timely blood components supply for the whole country was analysed. Standard quality control parameters for blood components, productivity and safety were compared from data collected with the conventional semi- automated buffy coat method and with FAS/PRT. The FAS decreased processing time when compared with the buffy coat method and facilitated the daily routine at the LRC. Red blood cell concentrates, plasma units and PCs prepared with both methods were conform to the European Directorate for the Quality of Medicines & HealthCare specifications. PCs prepared by FAS showed high yields, with decreased variability when the device-related software (T-Pool Select) was used. PRT had minimal impact on platelet yields and product quality and induced no increase in transfusion reaction notifications. The FAS and PRT transformed the daily routine of blood component manufacture by allowing increased productivity and efficiency, notwithstanding resource containment and without impacting quality, yet promoting safety.
Topics: Automation; Blood Component Transfusion; Blood Platelets; Blood Preservation; Blood Safety; Erythrocytes; Humans; Luxembourg; Plasma; Platelet Count; Platelet Transfusion; Quality Control; Red Cross; Retrospective Studies; Riboflavin; Software
PubMed: 34147359
DOI: 10.1016/j.transci.2021.103195 -
Journal of Feline Medicine and Surgery Aug 2019Despite the increasing availability of feline blood collected and stored for transfusion purposes, few studies have been performed on feline blood units. The aim of this...
OBJECTIVES
Despite the increasing availability of feline blood collected and stored for transfusion purposes, few studies have been performed on feline blood units. The aim of this prospective in vitro study was to evaluate haematological and morphological changes in feline blood cells in whole blood units between collection and end of storage.
METHODS
Haematological examination (red blood cells [RBCs], haemoglobin, haematocrit, red cell distribution width, mean cell volume, mean cell haemoglobin concentration, mean cell haemoglobin, white blood cells [WBCs] and platelet [PLT] count) was performed on 40 non-leukoreduced feline whole blood units at the time of collection (day[D]0) and after storage (D35). The blood was collected into citrate-phosphate-dextrose-adenine anticoagulant-preservative solution using an open system in a veterinary blood bank and stored for 35 days at 4 ± 2°C. Twenty of these feline whole blood units were also analysed for blood cell morphology (normal RBCs, macrocytes, echinocytes, spherocytes, schistocytes, lysed RBCs, RBCs with Heinz bodies and recognisable WBC and PLT count). Differences between the two examination times were statistically analysed.
RESULTS
There was a statistically significant decrease in WBC and PLT counts after storage at D35 ( <0.0001 for both). The most significant cellular morphological changes after storage were an increase in echinocyte count ( = 0.0001), and lysed RBCs ( <0.0001), and a decrease in normal RBCs ( <0.0001). Recognisable WBCs - mainly lymphocytes - were present at the end of storage.
CONCLUSIONS AND RELEVANCE
This study showed that significant morphological changes occur in RBCs in feline blood units during storage for 35 days. In vivo studies are required to establish if these changes could affect the ability of stored RBCs to circulate and provide adequate oxygen delivery after transfusion.
Topics: Animals; Blood Physiological Phenomena; Blood Preservation; Blood Transfusion; Cats; Hematologic Tests; Prospective Studies
PubMed: 30226393
DOI: 10.1177/1098612X18798841 -
Respiratory Care Jul 2006
Topics: Blood Gas Analysis; Blood Preservation; Glass; Humans; Oxygen; Partial Pressure; Plastics; Solubility; Temperature; Time Factors
PubMed: 16800902
DOI: No ID Found