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transfusion physiology

Victoria A McCredie, Simone Piva, Marlene Santos, Wei Xiong, Airton Leonardo de Oliveira Manoel, Andrea Rigamonti, Gregory M T Hare, Martin G Chapman, Andrew J Baker
BACKGROUND: There are a range of opinions on the benefits and thresholds for the transfusion of red blood cells in critically ill patients with traumatic brain injury (TBI) and an urgent need to understand the neurophysiologic effects. The aim of this study was to examine the influence of red blood cell transfusions on cerebral tissue oxygenation (SctO2) in critically ill TBI patients. METHODS: This prospective observational study enrolled consecutive TBI patients with anemia requiring transfusion...
October 18, 2016: Neurocritical Care
Ashima Sharma, Monu Yadav, B Rajesh Kumar, P Sai Lakshman, Raju Iyenger, Gopinath Ramchandran
BACKGROUND: A major change in anesthesia practice as regards to intraoperative infusion therapy is the present requirement. Switching over to balanced fluids can substantially decrease the incidence of lactic acidosis and hyperchloremic acidosis. The deleterious effects of unbalanced fluids are more recognizable during major surgeries. We prospectively studied the influence of Sterofundin (SF) and Ringer lactate (RL) on acid-base changes, hemodynamics, and readiness for extubation during scoliosis surgery...
September 2016: Anesthesia, Essays and Researches
Ayumi Shiraki, Wakana Azuma, Keiko Kuroda, H Roaki Ishii
Cupressoid (scale-like) leaves are morphologically and functionally intermediate between stems and leaves. While past studies on height acclimation of cupressoid leaves have focused on acclimation to the vertical light gradient, the relationship between morphology and hydraulic function remains unexplored. Here, we compared physiological and morphological characteristics between treetop and lower-crown leaves of 100-year-old Chamaecyparis obtusa Endl. trees (~27 m tall) to investigate whether height-acclimation compensates for hydraulic constraints...
October 15, 2016: Tree Physiology
Leo Kager, Lesley J Bruce, Petra Zeitlhofer, Joanna F Flatt, Tabita M Maia, M Leticia Ribeiro, Bernhard Fahrner, Gerhard Fritsch, Kaan Boztug, Oskar A Haas
We describe the second patient with anionic exchanger 1/band 3 null phenotype (band 3 null(VIENNA) ), which was caused by a novel nonsense mutation c.1430C>A (p.Ser477X) in exon 12 of SLC4A1. We also update on the previous band 3 null(COIMBRA) patient, thereby elucidating the physiological implications of total loss of AE1/band 3. Besides transfusion-dependent severe hemolytic anemia and complete distal renal tubular acidosis, dyserythropoiesis was identified in the band 3 null(VIENNA) patient, suggesting a role for band 3 in erythropoiesis...
October 8, 2016: Pediatric Blood & Cancer
Oliver Karam, Pierre Demaret, Alain Duhamel, Alison Shefler, Philip C Spinella, Simon J Stanworth, Marisa Tucci, Stéphane Leteurtre
BACKGROUND: Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions...
December 2016: Annals of Intensive Care
Jennifer A Muszynski, Philip C Spinella, Jill M Cholette, Jason P Acker, Mark W Hall, Nicole P Juffermans, Daniel P Kelly, Neil Blumberg, Kathleen Nicol, Jennifer Liedel, Allan Doctor, Kenneth E Remy, Marisa Tucci, Jacques Lacroix, Philip J Norris
Transfusion-related immunomodulation (TRIM) in the intensive care unit (ICU) is difficult to define and likely represents a complicated set of physiologic responses to transfusion, including both proinflammatory and immunosuppressive effects. Similarly, the immunologic response to critical illness in both adults and children is highly complex and is characterized by both acute inflammation and acquired immune suppression. How transfusion may contribute to or perpetuate these phenotypes in the ICU is poorly understood, despite the fact that transfusion is common in critically ill patients...
October 2, 2016: Transfusion
Anna L Peters, Renoja K Kunanayagam, Robin van Bruggen, Dirk de Korte, Nicole P Juffermans, Alexander P J Vlaar
BACKGROUND: Transfusion of a single unit of stored red blood cells (RBCs) has been hypothesized to induce supra-physiological levels of non-transferrin bound iron (NTBI), which may enhance inflammation and act as a nutrient for bacteria. We investigated the relation between RBC storage time and iron levels in a clinically relevant "two-hit" human transfusion model. STUDY DESIGN AND METHODS: Eighteen healthy male volunteers (ages 18-35 years) were infused with 2 ng lipopolysaccharide (LPS)/kg to induce systemic inflammatory response syndrome...
October 3, 2016: Transfusion
Yin Li
Enhanced recovery after surgery (ERAS) is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition and psychology. It aims to minimize surgical stress and maintain physiological function in perioperative care, thereby expediting recovery. ERAS theory has been clinically applied for nearly 20 years and it is firstly used in colorectal surgery, then widely used in other surgical fields. However, ERAS is not used commonly in esophagectomy because of its surgical complexity and high morbidity of postoperative complications, which limits the application of ERAS in the field of esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Claudia Delgado-Corcoran, Katherine H Wolpert, Kathryn Lucas, Stephanie Bodily, Angela P Presson, Susan L Bratton
OBJECTIVE: To determine whether judicious blood testing impacts timing or amount of packed RBC transfusions in infants after heart surgery. DESIGN: A retrospective study comparing before and after initiation of a quality improvement process. SETTING: A university-affiliated cardiac ICU at a tertiary care children's hospital. PATIENTS: Infants less than 1 year old with Risk Adjustment for Congenital Heart Surgery category 4, 5, 6, or d-transposition of great arteries (Risk Adjustment for Congenital Heart Surgery 3) consecutively treated during 2010 through 2013...
September 22, 2016: Pediatric Critical Care Medicine
Kelley L Baumgartel, Maureen W Groer, Susan M Cohen, Dianxu Ren, Diane L Spatz, Yvette P Conley
BACKGROUND: Maternal interleukin (IL) single nucleotide polymorphisms (SNPs) are associated with obstetrical outcomes. Conversely, infant SNPs are associated with subsequent neonatal intensive care unit (NICU) outcomes. Little is known about relationships between maternal SNPs and neonatal outcomes. PURPOSE: To examine the relationships between maternal IL genotypes and neonatal outcomes. METHODS: An ancillary study was conducted among mothers (N = 63) who delivered very low-birth-weight infants (N = 74)...
September 6, 2016: Biological Research for Nursing
Suzie A Noronha, S Christy Sadreameli, John J Strouse
Sickle cell disease (SCD) is a heterogeneous inherited disorder of hemoglobin that causes chronic hemolytic anemia, vaso-occlusion, and endothelial dysfunction. These physiologic derangements often lead to multiorgan damage in infancy and throughout childhood. The most common types of SCD are homozygous hemoglobin S (HbSS disease), hemoglobin SC disease, and sickle β thalassemia. HbSS disease and sickle β(0) thalassemia often are referred to as sickle cell anemia because they have similar severity. Screening and preventive measures, including infection prophylaxis and vaccination, have significantly improved outcomes for children with SCD...
September 2016: Southern Medical Journal
Margaret Kathleen Menzel Ellis, Mitchell Brett Sally, Darren Malinoski
INTRODUCTION: Despite continuous advances in transplant medicine, there is a persistent worldwide shortage of organs available for donation. There is a growing body of research that supports that optimal management of deceased organ donors in Intensive Care Unit can substantially increase the availability of organs for transplant and improve outcomes in transplant recipients. METHODS: A systematic literature review was performed, comprising a comprehensive search of the PubMed database for relevant terms, as well as individual assessment of references included in large original investigations, and comprehensive society guidelines...
July 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Anne Wikkelsø, Jørn Wetterslev, Ann Merete Møller, Arash Afshari
BACKGROUND: Severe bleeding and coagulopathy are serious clinical conditions that are associated with high mortality. Thromboelastography (TEG) and thromboelastometry (ROTEM) are increasingly used to guide transfusion strategy but their roles remain disputed. This review was first published in 2011 and updated in January 2016. OBJECTIVES: We assessed the benefits and harms of thromboelastography (TEG)-guided or thromboelastometry (ROTEM)-guided transfusion in adults and children with bleeding...
2016: Cochrane Database of Systematic Reviews
Tik Nga Tong, Emeralda Burke-Murphy, Darinka Sakac, Jacob Pendergrast, Christine Cserti-Gazdewich, Vincent Laroche, Donald R Branch
BACKGROUND: Various versions of the monocyte monolayer assay (MMA) have been used to assess clinical significance of red blood cell (RBC) alloantibodies in transfusion for more than 35 years. However, the optimal conditions, including anticoagulant used for whole blood samples, temperature and duration of storage, and optimal pH for assessing the response of monocytes to antibody-bound RBCs, have never been clearly delineated. STUDY DESIGN AND METHODS: Whole blood from healthy donors was collected in ACD, EDTA, or heparin and stored at room temperature (RT) versus 4°C for up to 2 days...
August 21, 2016: Transfusion
Fanny Bonhomme, Anne Godier, Charles Marc Samama, Thomas Lecompte, Pierre Fontana
BACKGROUND: Prasugrel provides rapid and intense inhibition of platelet aggregation combined with an increased risk of bleeding. We evaluated the efficacy and safety of platelet transfusion to reduce blood loss after a prasugrel loading dose in a rabbit model. STUDY DESIGN AND METHODS: Thirty-five rabbits were randomized into five groups: "control" (saline plus physiological buffer), "no-transfusion" (prasugrel plus physiological buffer), "platelet low dose" (prasugrel loading dose plus transfusion with a platelet count increase <80 × 10(9) /L), "platelet intermediate dose" (prasugrel loading dose plus transfusion with a platelet count increase 80-120 × 10(9) /L), and "platelet high dose" (prasugrel loading dose plus transfusion with a platelet count increase ≥120 × 10(9) /L)...
October 2016: Transfusion
Peep Talving, Konstantinos Chouliaras, Alexander Eastman, Margaret Lauerman, Pedro G Teixeira, Joseph DuBose, Joseph Minei, Thomas Scalea, Demetrios Demetriades
BACKGROUND: Discontinuity of the bowel following intestinal injury and resection is a common practice in damage control procedures for severe abdominal trauma. However, there are concerns that complete occlusion of the bowel, especially in the presence of hypotension or edema that may result in ischemic bowel changes or increase bacterial or toxin translocation. METHODS: This was a retrospective study from three Level-1 trauma centers. Included were trauma patients who required bowel resection and damage control...
August 19, 2016: World Journal of Surgery
Sarah L Harris, Nicola C Austin, Malcolm Battin, Roland Broadbent, John Horwood, Ross Keenan, Scott Wells, Carole Spencer, Patricia Graham, Lianne J Woodward, Brian A Darlow
AIMS: To describe the survival, in-hospital morbidity, brain metrics and two-year neurodevelopmental outcomes of two extremely preterm cohorts and discuss the contribution of changes in clinical practice to these outcomes. METHODS: Retrospective comparative cohort study, of two cohorts of neonates born <28 weeks gestation: 47 infants born 1998-2000 and 39 infants 2006-2009. RESULTS: Comparing historical to the contemporary cohort respectively, admission temperature (35...
2016: New Zealand Medical Journal
Burak Zeybek, Andrew M Childress, Gokhan S Kilic, John Y Phelps, Luis D Pacheco, Michele A Carter, Mostafa A Borahay
IMPORTANCE: Obstetricians and gynecologists frequently deal with hemorrhage so they should be familiar with management of patients who refuse blood transfusion. Although there are some reports in the literature about management of Jehovah's Witness patients in obstetrics and gynecology, most of them are case reports, and a comprehensive review about these patients including ethicolegal perspective is lacking. OBJECTIVE: This review outlines the medical, ethical, and legal implications of management of Jehovah's Witness patients in obstetrical and gynecological settings...
August 2016: Obstetrical & Gynecological Survey
Xiaoyun Fu, Jacob R Felcyn, Katherine Odem-Davis, James C Zimring
BACKGROUND: Accumulation of bioactive lipids during red blood cell (RBC) storage has been identified as a potential source of posttransfusion sequelae in vulnerable populations. Typically, white blood cells (WBCs) have been implicated in the generation of bioactive lipids, and leukoreduction has been seen as a solution to this issue. STUDY DESIGN AND METHODS: We developed a targeted metabolomics approach with isotope dilution to quantify a panel of bioactive lipids in both leukoreduced (LR) and nonleukoreduced (NLR) RBC units over the course of storage...
October 2016: Transfusion
R M Surve, R Muthuchellappan, G S U Rao, M Philip
BACKGROUND: Literature suggests poorer outcomes during anaemia as well as following red blood cell transfusion (BT) in brain injured patients. Recently, central venous oxygen saturation (ScvO2 ) has been proposed as a physiological trigger to guide red BT. In this study, we looked at ScvO2 changes following BT in patients admitted to a neurointensive care unit (NICU). STUDY DESIGN: In this prospective, observational study, adult, acutely ill neurological patients of >18 years were recruited...
August 1, 2016: Transfusion Medicine
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