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transfusion physiology

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https://www.readbyqxmd.com/read/27925235/quantification-of-operational-learning-in-minimal-invasive-extracorporeal-circulation
#1
Kyriakos Anastasiadis, Polychronis Antonitsis, Christos Asteriou, Helena Argiriadou, Apostolos Deliopoulos, Dimitrios Konstantinou, Vassilios Grosomanidis, Paschalis Tossios
Minimal invasive extracorporeal circulation (MiECC) has initiated important new efforts within science and technology towards a more physiologic perfusion. In this study, we aim to investigate the learning curve of our center regarding MiECC. We studied a series of 150 consecutive patients who underwent elective coronary artery bypass grafting by the same surgical team during the initial phase of MiECC application. Patients were randomly assigned into two groups. Group A (n = 75) included patients operated on MiECC, while group B (n = 75) included patients operated with conventional cardiopulmonary bypass (cCPB)...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27919118/preeclampsia-and-the-risk-of-bronchopulmonary-dysplasia-in-preterm-infants-less-than-32-weeks-gestation
#2
Nancy Soliman, Kathleen Chaput, Belal Alshaikh, Kamran Yusuf
Objective Angiogenesis is essential for normal lung development. The objective of our study was to test the hypothesis that preeclampsia, an antiangiogenic state, is a risk factor for bronchopulmonary dysplasia (BPD). Design Prospective cohort study of infants less than 32 weeks' gestation born to mothers with preeclampsia between January 2007 and June 2010 at a single tertiary care center. Their BPD outcome was compared with infants born to the next two normotensive mothers with a ± 1 week gestational age difference...
December 5, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27893645/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#3
Clay Cothren Burlew, Ernest E Moore, Philip F Stahel, Andrea E Geddes, Amy E Wagenaar, Fredric M Pieracci, Charles J Fox, Eric M Campion, Jeffrey L Johnson, Cyril Mauffrey
BACKGROUND: A 2015 AAST trial reported a 32% mortality for pelvic fracture patients in shock. Angioembolization (AE) is the most common intervention; the Maryland group revealed time to AE averaged 5 hours. The goal of this study was to evaluate the time to intervention and outcomes of an alternative approach for pelvic hemorrhage. We hypothesized preperitoneal pelvic packing (PPP) results in a shorter time to intervention and lower mortality. METHODS: In 2004 we initiated a PPP protocol for pelvic fracture hemorrhage...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27827796/effect-of-body-position-and-ventilation-on-umbilical-artery-and-venous-blood-flows-during-delayed-umbilical-cord-clamping-in-preterm-lambs
#4
Stuart B Hooper, Kelly J Crossley, Valerie A Zahra, Jeroen van Vonderen, Alison Moxham, Andrew W Gill, Martin Kluckow, Arjan B Te Pas, Euan M Wallace, Graeme R Polglase
OBJECTIVE: While delayed umbilical cord clamping (UCC) is thought to facilitate placental to infant blood transfusion, the physiological factors regulating flow in the umbilical arteries and veins during delayed UCC is unknown. We investigated the effects of gravity, by changing fetal height relative to the placenta, and ventilation on umbilical blood flows and the cardiovascular transition during delayed UCC at birth. METHODS: Catheters and flow probes were implanted into preterm lambs (128 days) prior to delivery to measure pulmonary, carotid, umbilical artery (UaBF) and umbilical venous (UvBF) blood flows...
November 8, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27792859/emerging-cellular-and-gene-therapies-for-congenital-anemias
#5
REVIEW
Leif S Ludwig, Rajiv K Khajuria, Vijay G Sankaran
Congenital anemias comprise a group of blood disorders characterized by a reduction in the number of peripherally circulating erythrocytes. Various genetic etiologies have been identified that affect diverse aspects of erythroid physiology and broadly fall into two main categories: impaired production or increased destruction of mature erythrocytes. Current therapies are largely focused on symptomatic treatment and are often based on transfusion of donor-derived erythrocytes and management of complications...
October 28, 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/27779595/sympathoadrenal-activation-and-endotheliopathy-are-drivers-of-hypocoagulability-and-hyperfibrinolysis-in-trauma-a-prospective-observational-study-of-404-severely-injured-patients
#6
Sisse R Ostrowski, Hanne H Henriksen, Jakob Stensballe, Mikkel Gybel-Brask, Jessica C Cardenas, Lisa A Baer, Bryan A Cotton, John B Holcomb, Charles E Wade, Pär I Johansson
BACKGROUND: One third of severely injured patients present with a laboratory based diagnosis of coagulopathy. This study investigated clinical and biomarker profile of patients with rapid TEG (rTEG) coagulopathy hypothesizing that sympathoadrenal activation and endothelial damage were drivers of this condition. METHODS: Prospective observational study of 404 trauma patients admitted to a Level 1 US Trauma Center. Patients with admission rTEG and plasma measurements of catecholamines (adrenaline, noradrenaline) and biomarkers reflecting endothelial activation/damage (syndecan-1, thrombomodulin, sE-selectin, sVE-cadherin, nucleosomes) were included...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27767984/the-optimum-hematocrit
#7
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27757915/the-impact-of-red-blood-cell-transfusion-on-cerebral-tissue-oxygen-saturation-in-severe-traumatic-brain-injury
#8
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
https://www.readbyqxmd.com/read/27746547/a-comparative-study-of-sterofundin-and-ringer-lactate-based-infusion-protocol-in-scoliosis-correction-surgery
#9
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
https://www.readbyqxmd.com/read/27744383/physiological-and-morphological-acclimation-to-height-in-cupressoid-leaves-of-100-year-old-chamaecyparis-obtusa
#10
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
https://www.readbyqxmd.com/read/27718309/band-3-null-vienna-a-novel-homozygous-slc4a1-p-ser477x-variant-causing-severe-hemolytic-anemia-dyserythropoiesis-and-complete-distal-renal-tubular-acidosis
#11
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
https://www.readbyqxmd.com/read/27714707/performance-of-the-pediatric-logistic-organ-dysfunction-2-score-in-critically-ill-children-requiring-plasma-transfusions
#12
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
https://www.readbyqxmd.com/read/27696473/transfusion-related-immunomodulation-review-of-the-literature-and-implications-for-pediatric-critical-illness
#13
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
https://www.readbyqxmd.com/read/27696454/transfusion-of-35-day-stored-red-blood-cells-does-not-result-in-increase-of-plasma-non-transferrin-bound-iron-in-human-endotoxemia
#14
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
https://www.readbyqxmd.com/read/27680060/-strategy-and-prospective-of-enhanced-recovery-after-surgery-for-esophageal-cancer
#15
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
https://www.readbyqxmd.com/read/27662564/hematocrit-levels-blood-testing-and-blood-transfusion-in-infants-after-heart-surgery
#16
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...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27605567/maternal-interleukin-genotypes-are-associated-with-nicu-outcomes-among-low-birth-weight-infants
#17
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
https://www.readbyqxmd.com/read/27598348/management-of-sickle-cell-disease-in-children
#18
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
https://www.readbyqxmd.com/read/27555674/the-development-and-current-status-of-intensive-care-unit-management-of-prospective-organ-donors
#19
REVIEW
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
https://www.readbyqxmd.com/read/27552162/thromboelastography-teg-or-thromboelastometry-rotem-to-monitor-haemostatic-treatment-versus-usual-care-in-adults-or-children-with-bleeding
#20
REVIEW
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...
August 22, 2016: Cochrane Database of Systematic Reviews
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