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transfusion physiology

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https://www.readbyqxmd.com/read/29144508/ly6g-neutrophil-derived-mir-223-inhibits-the-nlrp3-inflammasome-in-mitochondrial-damp-induced-acute-lung-injury
#1
Zunyong Feng, Shimei Qi, Yue Zhang, Zhilin Qi, Liang Yan, Jing Zhou, Fang He, Qianqian Li, Yanyan Yang, Qun Chen, Shi Xiao, Qiang Li, Yang Chen, Yao Zhang
MicroRNA (miRNA) mediates RNA interference to regulate a variety of innate immune processes, but how miRNAs coordinate the mechanisms underlying acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in patients with pulmonary inflammatory injury is still unknown. In this study, we demonstrated that miR-223 limits the number of Ly6G+ neutrophils and inhibits the activity of the NLRP3 inflammasome to alleviate ALI induced by mitochondrial damage-associated molecular patterns (DAMPs) (MTDs). miR-223 expression is increased in the lungs of MTD-induced mice or ARDS patients following trauma/transfusion or following the physiological remission of ALI/ARDS...
November 16, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/29097365/refrigeration-induced-binding-of-von-willebrand-factor-facilitates-fast-clearance-of-refrigerated-platelets
#2
Wenchun Chen, Samuel A Druzak, Yingchun Wang, Cassandra D Josephson, Karin M Hoffmeister, Jerry Ware, Renhao Li
OBJECTIVE: Apheresis platelets for transfusion treatment are currently stored at room temperature because after refrigeration platelets are rapidly cleared on transfusion. In this study, the role of von Willebrand factor (VWF) in the clearance of refrigerated platelets is addressed. APPROACH AND RESULTS: Human and murine platelets were refrigerated in gas-permeable bags at 4°C for 24 hours. VWF binding, platelet signaling events, and platelet post-transfusion recovery and survival were measured...
November 2, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29095001/glutaminemia-prognostic-significance-in-critical-surgical-patients-an-analysis-of-plasma-aminogram-profile
#3
Beatriz Pinto Costa, Paulo Martins, Carla Verissimo, Marta Simões, Marisa Tomé, Manuela Grazina, Jorge Pimentel, Francisco Castro Sousa
BACKGROUND: Glutamine depletion is common in the critically-ill patients. Glutaminemia lower than 420 μmol/l has been considered as an independent predictive factor of mortality, but the indications for exogenous glutamine supplementation remain controversial. This study intends to determine the glutaminemia profile in critical surgical patients and to investigate its correlation with the severity indexes and the prognosis. METHODS: A prospective study of 28 adult critical surgical patients was performed...
July 28, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29092656/effect-of-anemia-on-mortality-in-mechanically-ventilated-patients-with-chronic-obstructive-pulmonary-disease
#4
Shruti K Gadre, Aravdeep Singh Jhand, Sami Abuqayyas, Xiaofeng Wang, Jorge Guzman, Abhijit Duggal
RATIONALE: The effect of anemia on patients with chronic obstructive pulmonary disease (COPD) requiring invasive mechanical ventilation for acute respiratory failure is unknown. OBJECTIVES: To examine the association between anemia (hemoglobin <12 g/dL) and 90-day and overall mortality in patients with COPD having acute respiratory failure requiring invasive mechanical ventilation. METHODS: Retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between October 2007 and December 2012 with a diagnosis of COPD and requiring invasive mechanical ventilation for acute respiratory failure of any cause...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29090212/metabolism-of-citrate-and-other-carboxylic-acids-in-erythrocytes-as-a-function-of-oxygen-saturation-and-refrigerated-storage
#5
Travis Nemkov, Kaiqi Sun, Julie A Reisz, Tatsuro Yoshida, Andrew Dunham, Edward Y Wen, Alexander Q Wen, Rob C Roach, Kirk C Hansen, Yang Xia, Angelo D'Alessandro
State-of-the-art proteomics technologies have recently helped to elucidate the unanticipated complexity of red blood cell metabolism. One recent example is citrate metabolism, which is catalyzed by cytosolic isoforms of Krebs cycle enzymes that are present and active in mature erythrocytes and was determined using quantitative metabolic flux analysis. In previous studies, we reported significant increases in glycolytic fluxes in red blood cells exposed to hypoxia in vitro or in vivo, an observation relevant to transfusion medicine owing to the potential benefits associated with hypoxic storage of packed red blood cells...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29070551/current-understanding-of-iron-homeostasis
#6
REVIEW
Gregory J Anderson, David M Frazer
Iron is an essential trace element, but it is also toxic in excess, and thus mammals have developed elegant mechanisms for keeping both cellular and whole-body iron concentrations within the optimal physiologic range. In the diet, iron is either sequestered within heme or in various nonheme forms. Although the absorption of heme iron is poorly understood, nonheme iron is transported across the apical membrane of the intestinal enterocyte by divalent metal-ion transporter 1 (DMT1) and is exported into the circulation via ferroportin 1 (FPN1)...
October 25, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29065752/is-blood-transfusion-necessary-in-all-patients-with-disseminated-intravascular-coagulation-associated-postpartum-hemorrhage
#7
Hale Goksever Celik, Engin Celik, Ismail Ozdemir, Ayse Ozge Savkli, Kamuran Sanli, Husnu Gorgen
OBJECTIVE: The diagnosis of disseminated intravascular coagulation (DIC) in obstetrics is complicated owing to physiological changes, particularly during late pregnancy and the postpartum period. Therefore, a pregnancy-modified DIC score that includes only three components of the International Society on Thrombosis and Hemostasis (ISTH) DIC score has been constructed. Our aim was to determine how many blood-transfused postpartum women actually had the diagnosis of overt DIC according to the modified ISTH score and had the correct indications for blood transfusion...
October 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29064875/perioperative-patient-blood-management-to-improve-outcomes
#8
Neel Desai, Nick Schofield, Toby Richards
Anemia is common in elective surgery and is an independent risk factor for morbidity and mortality. Historical management of anemia has focused on the use of allogeneic blood transfusion but this in itself is not without risk. It too has been independently associated with morbidity and mortality, let alone the costs and relative shortage of this resource. In recognition of this, patient blood management (PBM) shifts the focus from the product to the patient and views the patient's own blood as a resource that should be conserved and managed appropriately as a standard of care...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29061498/effect-of-a-red-blood-cell-transfusion-on-biological-markers-used-to-determine-the-cause-of-anemia-a-prospective-study
#9
Antoine Froissart, Benjamin Rossi, Brigitte Ranque, Irène Jarrin, Jean-François Bergmann, Sébastien Beaune, Sandrine Dautheville, Nicole Breau, Agnès Dauvergne, Lauréline Deluche, Tiphaine Robert, Nathalie Gault, Carine Roy, Virginie Zarrouk, Olivier Steichen, Bruno Fantin
BACKGROUND: Blood test results required for the evaluation of anemia are considered difficult to interpret after red blood cell transfusion. However, this hypothesis is neither supported by a strong physiological rationale nor is it evidence based. METHODS: We conducted a prospective multicenter study to compare the values of key assays before and after a course of red blood cell transfusion in the emergency or internal medicine units in four university hospitals...
October 20, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29061269/comparison-of-percutaneous-versus-open-femoral-cutdown-access-for-endovascular-repair-of-ruptured-abdominal-aortic-aneurysms
#10
COMPARATIVE STUDY
Samuel L Chen, Nii-Kabu Kabutey, Matthew D Whealon, Isabella J Kuo, Roy M Fujitani
OBJECTIVE: Ruptured endovascular aortic aneurysm repair (REVAR) is being increasingly used to treat ruptured abdominal aortic aneurysms (rAAAs). However, the comparison between totally percutaneous (pREVAR) vs femoral cutdown (cREVAR) access for REVAR has not been studied. We used a national surgical database to evaluate the 30-day outcomes in patients undergoing pREVAR vs cREVAR. METHODS: Patients who underwent EVAR for rAAA between 2011 and 2014, inclusively, were studied in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular database...
November 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29046959/minimally-invasive-liver-resection-for-primary-and-metastatic-liver-tumors-influence-of-age-on-perioperative-complications-and-mortality
#11
Iswanto Sucandy, Susannah Cheek, Allan Tsung, J Wallis Marsh, David A Geller
BACKGROUND: As minimally invasive technique becomes more popular, an increasing number of elderly patients were considered for minimally invasive liver resection (MILR). Limited physiologic reserve remains a major concern, which frequently leads surgeons to recommend nonresectional alternatives. We sought to evaluate complications and outcomes of elderly patients undergoing MILR. METHODS: Eight hundred and thirty-one patients who underwent MILR were classified into groups A, B, and C based on age [(< 70, n = 629), (70-79, n = 148), (≥ 80, n = 54) years old, respectively]...
October 18, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29036406/effects-of-computerized-decision-support-system-implementations-on-patient-outcomes-in-inpatient-care-a-systematic-review
#12
Julian Varghese, Maren Kleine, Sophia Isabella Gessner, Sarah Sandmann, Martin Dugas
Objectives: To systematically classify the clinical impact of computerized clinical decision support systems (CDSSs) in inpatient care. Materials and Methods: Medline, Cochrane Trials, and Cochrane Reviews were searched for CDSS studies that assessed patient outcomes in inpatient settings. For each study, 2 physicians independently mapped patient outcome effects to a predefined medical effect score to assess the clinical impact of reported outcome effects. Disagreements were measured by using weighted kappa and solved by consensus...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28985389/water-retained-in-tall-cryptomeria-japonica-leaves-as-studied-by-infrared-micro-spectroscopy
#13
Wakana Azuma, Satoru Nakashima, Eri Yamakita, H Roaki Ishii, Keiko Kuroda
Recent studies in the tallest tree species suggest that physiological and anatomical traits of tree-top leaves are adapted to water-limited conditions. In order to examine water retention mechanism of leaves in a tall tree, infrared (IR) micro-spectroscopy was conducted on mature leaf cross-sections of tall Cryptomeria japonica D. Don from four different heights (51, 43, 31 and 19 m). We measured IR transmission spectra and mainly analyzed OH (3700-3000 cm-1) and C-O (1190-845 cm-1) absorption bands, indicating water molecules and sugar groups, respectively...
October 1, 2017: Tree Physiology
https://www.readbyqxmd.com/read/28984630/perioperative-management-of-the-adult-patient-on-venovenous-extracorporeal-membrane-oxygenation-requiring-noncardiac-surgery
#14
Michael A Fierro, Mani A Daneshmand, Raquel R Bartz
The use of venovenous extracorporeal membrane oxygenation is increasing worldwide. These patients often require noncardiac surgery. In the perioperative period, preoperative assessment, patient transport, choice of anesthetic type, drug dosing, patient monitoring, and intraoperative and postoperative management of common patient problems will be impacted. Furthermore, common monitoring techniques will have unique limitations. Importantly, patients on venovenous extracorporeal membrane oxygenation remain subject to hypoxemia, hypercarbia, and acidemia in the perioperative setting despite extracorporeal support...
October 4, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28969312/viscoelastometric-guided-early-fibrinogen-concentrate-replacement-during-postpartum-haemorrhage-obs2-a-double-blind-randomized-controlled-trial
#15
P W Collins, R Cannings-John, D Bruynseels, S Mallaiah, J Dick, C Elton, A D Weeks, J Sanders, N Aawar, J Townson, K Hood, J E Hall, R E Collis
Background: Postpartum haemorrhage (PPH) can be exacerbated by haemostatic failure. We hypothesized that early fibrinogen replacement, guided by viscoelastometric testing, reduces blood product usage and bleed size. Methods: Women with PPH 1000-1500 ml were enrolled. If Fibtem A5 was ≤15 mm and bleeding continued, subjects were randomized to fibrinogen concentrate or placebo. The primary outcome compared the number of units of red blood cells, plasma, cryoprecipitate and platelets transfused...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28960897/a-uniform-shear-rate-microfluidic-bioreactor-for-real-time-study-of-proplatelet-formation-and-rapidly-released-platelets
#16
Andres F Martinez, Richard D McMahon, Marc Horner, William M Miller
Platelet transfusions, with profound clinical importance in blood clotting and wound healing, are entirely derived from human volunteer donors. Hospitals rely on a steady supply of donations, but these methods are limited by a 5-day shelf life, the potential risk of contamination, and differences in donor/recipient histocompatibility. These challenges invite the opportunity to generate platelets ex vivo. Although much progress has been made in generating large numbers of culture-derived megakaryocytes (Mks, the precursor cells to platelets), stimulating a high percentage of Mks to undergo platelet release remains a major challenge...
September 27, 2017: Biotechnology Progress
https://www.readbyqxmd.com/read/28952974/assessment-of-mesenteric-tissue-saturation-oxygen-saturation-and-heart-rate-pre-and-post-blood-transfusion-in-very-low-birth-weight-infants-using-abdominal-site-near-infrared-spectroscopy
#17
Harriet D Miller, Daleen A Penoyer, Kari Baumann, Ann Diaz, Mary Lou Sole, Susan M Bowles
BACKGROUND: Preterm infants often receive blood transfusions during hospitalization. Although transfusions are intended to enhance oxygen delivery, previous studies found decreases in tissue and mesenteric oxygen saturation during and after blood transfusions without changes in vital signs and hemoglobin oxygen saturation. PURPOSE: To study the effect of blood transfusions on regional mesenteric tissue oxygen saturation (rSO2), hemoglobin saturation of oxygen (SpO2), and heart rate (HR) in premature infants...
August 3, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28948619/analysis-of-pediatric-adverse-reactions-to-transfusions
#18
Sarah Vossoughi, Gabriela Perez, Barbee I Whitaker, Mark K Fung, Brie Stotler
BACKGROUND: Children are known to be physiologically and biochemically different from adults. However, there are no multi-institutional studies examining the differences in the frequency, type, and severity of transfusion reactions in pediatric versus adult patients. This study aims to characterize differences between pediatric and adult patients regarding adverse responses to transfusions. STUDY DESIGN AND METHODS: This is a retrospective data analysis of nine children's hospitals and 35 adult hospitals from January 2009 through December 2015...
September 25, 2017: Transfusion
https://www.readbyqxmd.com/read/28941545/transfusion-decision-making-in-pediatric-critical-illness
#19
REVIEW
Chris Markham, Peter Hovmand, Allan Doctor
Transfusion decision making (TDM) in the critically ill requires consideration of: (1) anemia tolerance, which is linked to active pathology and to physiologic reserve, (2) differences in donor RBC physiology from that of native RBCs, and (3) relative risk from anemia-attributable oxygen delivery failure vs hazards of transfusion, itself. Current approaches to TDM (e.g. hemoglobin thresholds) do not: (1) differentiate between patients with similar anemia, but dissimilar pathology/physiology, and (2) guide transfusion timing and amount to efficacy-based goals (other than resolution of hemoglobin thresholds)...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28930957/clot-dynamics-and-mortality-the-ma-r-ratio
#20
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing thromboelastography (TEG) to identify those at risk of subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
October 2017: Journal of Trauma and Acute Care Surgery
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