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Introducción. La resucitación hemostática es una estrategia para compensar la pérdida sanguínea y disminuir el impacto de la coagulación inducida por trauma. Debido a que la disponibilidad de transfundir una razón equilibrada de hemocomponentes es difícil de lograr en el entorno clínico, la sangre total ha reaparecido como una estrategia fisiológica, con ventajas logísticas, que le permiten ser accesible para iniciar tempranamente la resucitación hemostática. El objetivo de este estudio fue evaluar las propiedades celulares, coagulantes y viscoelásticas de la sangre total almacenada por 21 días. Métodos. Las unidades de sangre total fueron obtenidas de 20 donantes voluntarios sanos. Se procesaron mediante un sistema de leucorreducción ahorrador de plaquetas y fueron almacenadas en refrigeración (1-6°C) sin agitación. Se analizaron los días 0, 6, 11 y 21. Las bolsas fueron analizadas para evaluar las líneas celulares, niveles de factores de coagulación y propiedades viscoelásticas mediante tromboelastografía. Resultados. El conteo eritrocitario y la hemoglobina se mantuvieron estables. El conteo de plaquetas tuvo una reducción del 50 % al sexto día, pero se mantuvo estable el resto del seguimiento. Los factores de coagulación II-V-VII-X, fibrinógeno y proteína C se mantuvieron dentro del rango normal. La tromboelastografía mostró una prolongación en el tiempo del inicio de la formación del coágulo, pero sin alterar la formación final de un coágulo estable. Conclusiones. La sangre total leucorreducida y con filtro ahorrador de plaquetas conserva sus propiedades hemostáticas por 21 días. Este es el primer paso en Colombia para la evaluación clínica de esta opción, que permita hacer una realidad universal la resucitación hemostática del paciente con trauma severo.
Background. Hemostatic resuscitation is a strategy to compensate blood loss and reduce the impact of trauma-induced coagulopathy. However, balanced resuscitation presents challenges in its application in the clinical setting. Whole blood has re-emerged as a physiologic strategy with logistical advantages that offer the opportunity for early initiation of hemostatic resuscitation. The study aims to evaluate the cellular, coagulation, and viscoelastic properties of whole blood preserved for 21 days. Methods. Whole blood units were donated by 20 healthy volunteers. These units were processed using a platelet-sparing leukoreduction filtration system. Units were stored under refrigeration (1-6°C) without agitation and were sampled on days 0, 6, 11, 16, and 21. The units were tested to assess its cellular properties and coagulation factors levels. In addition, viscoelastic features were tested using tromboelastography.Results. Red blood cells count and hemoglobin levels remained stables. Platelet count had a 50% reduction on day 6, and then remained stable for 21 days. Factors II-V-VII-X, fibrinogen, and protein C remained within normal range. Tromboelastrography test showed that the reaction time of clot formation is prolonged, but the final clot formation is not altered. Conclusion. Whole blood retains its hemostatic properties for 21 days. This is the first step to evaluate the use of whole blood in the resuscitation protocols for Colombia allowing hemostatic resuscitation become a universal reality.
Subject(s)
Humans , Resuscitation , Blood Preservation , Shock, Hemorrhagic , Blood , Blood Transfusion , HemostasisABSTRACT
White blood cells (WBCs) and storage period are the main factors of transfusion reactions. In the present study, cytokine/chemokine concentrations after leukoreduction (LR) and irradiation (IR) in stored canine whole blood were measured. Red blood cell storage lesion caused by IR and LR were also compared. Blood samples from 10 healthy Beagles were divided into four groups (no treatment, LR-, IR-, and LR + IR-treated). Leukocytes were removed by filtration in the LR group and gamma radiation (25 Gy) was applied in the IR group. Immunologic factors (WBCs, interleukin-6 [IL-6], C-X-C motif chemokine ligand 8 [CXCL-8], and tumor necrosis factor-alpha) and storage lesion factors (blood pH, potassium, and hemolysis) were evaluated on storage days 0, 7, 14, 21, and 28. Compared to the treated groups, IL-6 and CXCL-8 concentrations during storage were significantly higher in the control (no treatment) group. LR did not show changes in cytokine/chemokine concentrations, and storage lesion presence was relatively mild. IR significantly increased CXCL-8 after 14 days of storage, but IR of leukoreduced blood did not increase CXCL-8 during 28 days of storage. Storage lesions such as hemolysis, increased potassium, and low pH were observed 7 days after IR and storage of blood, regardless of LR. IR of leukoreduced blood is beneficial to avoid immune reactions; however, storage lesions should be considered upon storage.
Subject(s)
Blood Preservation , Down-Regulation , Erythrocytes , Filtration , Gamma Rays , Hemolysis , Hydrogen-Ion Concentration , Immunologic Factors , Interleukin-6 , Leukocyte Reduction Procedures , Leukocytes , Necrosis , Potassium , Transfusion ReactionABSTRACT
Abstract Objective: To describe the reasons for the disposal of blood in the coordinating blood center of the State of Paraná and to estimate the financial costs resulting from potentially avoidable discards. Method: A descriptive, retrospective and documentary analysis, with data related to the period from 2010 to 2015 of a Brazilian coordinating blood center collected from a governmental database and analyzed by descriptive statistics. This study was approved by the Ethics Research Committee (CAEE 63074916.0.0000.5225). Results: 101,813 units were discarded, representing 22.3% of the total of 455,684 produced; plasma was the most discharged blood component. The main reason for discarding was lipemia (35.8%); the analysis showed that 56.9% of the disposals were considered potentially avoidable with an estimated paid value of approximately US$2 million. Conclusion: The expressive potential of avoidance of disposal of blood units and blood components highlights the importance of planning actions aiming at their best use, contributing to the reduction of amounts paid for these processes.
Resumen Objetivo: Describir las causas de desechos de sangre en un hemocentro coordinador del estado de Paraná y estimar los costos financieros recurrentes de desechos potencialmente evitables. Método: Descriptivo, retrospectivo y análisis documental, con datos relativos al período de 2010 a 2015 de un hemocentro coordinador brasileño recolectados a partir de la base del Sistema Hemovida y analizados por estadística descriptiva. El proyecto fue aprobado por el Comité de Ética en Investigación con el número CAEE 63074916.0.0000.5225. Resultados: Se desecharon 101.813 unidades, lo que representa el 22,3% del total de 455.684 producidas; el plasma fue el hemocomponente más desechado. Hubo predominio de desecho por lipemia (35,8%); y el análisis demostró que el 56,9% de los desechos se consideraron potencialmente evitables, un valor pago estimado de US$2 millones. Conclusión: El significativo potencial de evitar el desecho de unidades de sangre y hemocomponentes destaca la importancia de planificar acciones con vistas a mejorar el uso, contribuyendo así a reducir los costos de las tarifas que se pagan por estos procesos.
Resumo Objetivo: Descrever os motivos de descarte de sangue no hemocentro coordenador do Estado do Paraná e estimar os custos financeiros decorrente de descartes potencialmente evitáveis. Método: Descritivo, retrospectivo e análise documental, cujos dados relativos ao período de 2010 a 2015 foram coletados a partir de base do Sistema Hemovida, e analisados por estatística descritiva. O projeto foi aprovado pelo Comitê de Ética em Pesquisa sob CAEE 63074916.0.0000.5225. Resultados: Foram descartadas 101.813 unidades, que representaram 22,3% do total de 455.684 produzidas; o plasma foi o hemocomponente mais descartado. Houve prevalência de descarte por lipemia (35,8%); a análise demonstrou que 56,9% dos descartes foram considerados potencialmente evitáveis, um valor pago estimado de US$ 2 milhões. Conclusão: O expressivo potencial de evitabilidade de descarte de unidades de sangue e hemocomponentes destaca a importância no planejamento de ações com vistas ao seu melhor uso, contribuindo para a redução de valores pagos para esses processos.
Subject(s)
Humans , Blood , Medical Waste Disposal/economics , Costs and Cost Analysis , Brazil , Retrospective StudiesABSTRACT
Objective To analyze and evaluate the blood preservation effect of two types of blood transportation boxes under field conditions in extreme cold regions of the plain.Methods Before experiment,the hematocrit,hemoglobin(Hb) and free Hb content,Na+and K +of samples of suspended red blood cells(RBCs)were detected and the sterility test was conducted.One of the two boxes was a field blood transportation box that served as control, while the other was made of phase-changed material of two types—1#and 2#.The suspended RBC samples were preserved in the low-temperature blood refrigerators and the two types of boxes respectively and transported under outdoor environment temperatures of -20 --5℃for 2 h.After that,the changes in the blood storage device temperature were recorded after 0,12,24,36,48 and 60 h.Results The suspended RBC preservation time in the field blood transportation box was 42 h vs 58 h in the blood transportation box made of phase-changed material.But their hemolysis rate,Na+,K+and the sterility test all were up to national standards.Conclusion In the extreme cold regions of the plain, the blood transportation box made of phase-changed material can be used to preserve suspended RBCs.
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Objective To evaluate the quality of blood after marine storage and transportation,to establish a quantitative energy metabolism platform supported by extracellular flux(XF)technique to determine the glycolysis level of red blood cells(RBC), and to introduce the "functional dose", as a valuable supplement, into the quality evaluation of RBCs after marine storage and transportation.Methods The extracellular acidification rate(ECAR)of erythrocyte glycolysis was detected by XF.The levels of glycolysis, ATP contents and free hemoglobin of RBCs were detected before and after marine navigation.RBC suspensions stored at 4℃in a blood bank on land served as control.Results The results showed that the glycolysis level of RBCs was detected by XF.Indicators of blood quality and energy metabolism of RBCs were detected in the twice marine storage and transportation.Blood samples transported around the Gulf of Bohai had no significant change,indicating that the samples were well preserved.The energy indicators of blood samples navigated in the Pacific Ocean decreased significantly,and it was recommended that the samples be discarded.Conclusion XF technique has been applied to the measurement of erythrocyte glycolysis,enabling high-throughput and multi-indicator dynamic detection of viable cells.The energy metabolism of erythrocyte should be recommended as an important indicator for evaluating blood after marine storage and transportation.
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Objective To study the effects of environmental factors,including high temperature,high humidity and low temprtature,on the quality of whole blood.Methods Fresh blood was collected from 9 blood donors and divided into 40 parts.One group that comprised 20 samples was used to assess the effects of storage at high temperature and high humidity (0,3,6,12 and 24 h),and the other group(20 samples)was used to determine the effects of low temprtature(0,1,2 and 3 h).The serum free hemoglobin(FHb)concentration, plasma prothrombin time(PT), activated partial thromboplastin time(APTT),thrombin time(TT)and fibrinogen(FIB)were measured and analyzed.Results The high temperature(27-37℃)and humidity(60%-90%RH)had no effect on FHb, PT, APTT, TT or FIB of whole blood. The low temperature(0-13℃and -18--20℃)had some effect on the quality of whole blood.The FHb of test group was higher than that of control group.There was no significant difference in PT, APTT, TT and FIB between the two groups.Conclusion Under high temperature and humidity conditions, 24 hours of whole blood placement is feasible. Under low temperature or cold conditions,short-term whole blood placement is feasible in a tent with heating facilities.
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Objective To explore the influence on and changes in the biochemical indices of red blood cells(RBCs)in additive solution leukocytes reduced preserved in navy ship force on a long voyage.Methods According to the Requirement of Health Examination for Blood Donors(GB 18467 -2011),RBCs in additive solution leukocytes reduced were prepared from 10 healthy voluntary blood donators one day before sailing.Each blood sample was divided into two parts,one in test group and another in control group.All the groups had samples taken for the biochemical index detection after 1,3,5,7,14 and 21 days of sailing respectively.Results ①The change in total protein(P=0.235)and albumin (P=0.119)concentration was not obvious,and the difference between the two groups was not significant.②The change in total creatinine(P=0.001)and uric acid(P=0.001)concentration was obvious, but the difference between the two groups was not significant.③The change in total cholesterol(P=0.354)concentration was not obvious,but the change in triglycerides(P=0.005)concentration was significant.The difference between the two groups was not significant.④The concentration of lactate dehydrogenase, hydroxybutyrate dehydrogenase and creatine kinase increased with the time of preservation(P<0.001).The difference between the two groups was not significant.⑤The interaction between grouping effect and time effect had no significant influence on the concentration of osmolarity(OSM)(P=0.968)and glucose(Glu) (P=0.406).Between the two groups,the difference of concentrations of OSM(P=0.569)and Glu(P=0.115)was not significant.Conclusion Under the 4 class sea conditions, a long voyage has some impact on the storage of RBCs in additive solution leukocytes reduced,as in the conventional blood storage refrigerator(4 ±2)℃.The results of this study have important clinical implications for our further study of marine blood support.
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Objective To improve vibration resistance of conventional blood transportation kits and mitigate hemolysis during transportation.Methods The structure of a blood transportation kit was modified.We installed a suspension brac-kets within the kit,added buffer material between the brackets,and tested the vibration-suppressing effect compared with the conventional blood transportation kit.Results Rubber and plastic materials between brackets were added,and double membrane suspension brackets were installed.After 4 and 6 min of vibration,free hemoglobin(FHb)[(1559.7 ±1038.5) and(1886.2 ±1023.8)mg/L],lactic dehydrogenase levels[(135.3 ±67.7)and(195.7 ±123.6)U/L]and hemolysis rate[(0.35 ±0.34)%and(0.42 ±0.38)%]in the conventional transportation kit were significantly higher than in the vibration-suppressing kit.K+did not change significantly,and was comparable in both groups at each time point.After 4 and 6 min of vibration, FHb in the conventional transportation kit exceeded the standard.However, after 12 min of vibration,FHb[(560.1 ±342.3)mg/L]in the vibration-suppressing kit were within the standard range.No bacterial growth was detected in either group.Conclusion The vibration-suppressing kit under research shows a better 1986vibration-suppressing effect,which could improve blood support capability in case of emergency.
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Objective To study the changes in red blood cells(RBCs),hemoglobin(Hb),hematocrit(HCT),mean corpuscular volume(MCV),RBC distribution width variation coefficient(RDW-CV)and RBC distribution width standard deviation(RDW-SD)of leukocyte-poor red blood cells preserved in navy ship force on a long voyage.Methods According to the Requirement of Health Examination for Blood Donors(GB 18467 -2011),red blood cells in additive solution leukocytes reduced were randomly collected from ten healthy voluntary blood donors one day before sailing.Each blood sample was preserved.The relevant parameters were detected as data before sailing.Each blood sample was divided into two parts,one in test group and the other in control group.Samples were taken from the two groups of leukocyte-poor red blood cells for the sampling detection after 21 days of sailing respectively.Results ①After sailing, the concentrations of RBCs and Hb declined in both groups,and the difference of RBC concentrations was not significant(P=0.319),but that of the concentrations of Hb was significant(P=0.002).②After sailing, the concentrations of HCT and MCV increased, but the change of HCT was significant(P=0.015),while that of MCV was insignificant(P=0.051).③After sailing,the concentrations of RDW-SD and RDW-CV were higher,but the change of RDW-SD was significant(P<0.001),while that of RDW-CV was not(P=0.528).Conclusion When leukocyte-poor red blood cells are preserved in navy ship force,the concentrations of RBC and Hb decrease,while the concentrations of HCT,MCV,RDW-SD and RDW-CV increase with the prolongation of preservation.A long voyage has some impact on the parameters of red blood cells in additive solution leukocytes reduced,as is the case with the conventional blood storage refrigerator(4 ±2)℃.
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Objective To study the influences of hemolysis, fatty blood, storage temperature and storage time on blood HIV RNA and HBV DNA. Methods The HBV DNA and HIV RNA samples (the concentration was 12-30 times of limit of detection of reagent), which were stored for 4 h, 1 d, 3 d,1 w and 4 w under the conditions of 4℃, 25℃, 37℃and-30℃, were detected using Roche MPX V2.0 kit. The HBV DNA and HIV RNA samples (the concentration was 2-5 times of limit of detection of reagent) were detected by the 6 groups of hemolytic samples (the concentrations of hemoglobin were 97 g/L, 34 g/L,17 g/L, 8 g/L, 5 g/L and 3 g/L, respectively). NAT test was performed at 5-group lipid samples (the concentrations of triglyceride were 7.93 mmol/L, 3.80 mmol/L, 2.63 mmol/L, 1.83 mmol/L and 1.49 mmol/L, respectively) and the control group samples (the concentrations of hemoglobin and triglyceride were 0 g/L and 0.95 mmol/L respectively). Results There were no significant differences in Ct values of HIV RNA or HBV DNA between 4 h to 4 w at 25℃(P>0.05). There were significant differences in Ct values of HBV DNA after preservation for 3 d and 1 w under 37 ℃ compared with those of preservation for 4 h,1 d and 2 d (P<0.005). When Hb concentration was reached to 97 g/L, the results of HBV DNA and HIV RNA were negative. When the concentration of Hb was less than 34 g/L, compared with the control group, there were no significant differences in Ct values of HIV RNA and HBV DNA (P>0.05). When the TG concentration was≤7.93 mmol/L, there were no significant differences in Ct values between the control group and the TG group (P>0.05). Conclusion The samples of HIV RNA and HBV DNA detected by Roche MPX V2.0 kit can be stored at room temperature (25℃) for four weeks. When the concentrations of TG and Hb are less than 7.93 mmol/L and 34 g/L respectively, there are no effects on HIV RNA or HBV DNA samples detected by Roche MPX V2.0 kit.
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Objective To study the influences of hemolysis, fatty blood, storage temperature and storage time on blood HIV RNA and HBV DNA. Methods The HBV DNA and HIV RNA samples (the concentration was 12-30 times of limit of detection of reagent), which were stored for 4 h, 1 d, 3 d,1 w and 4 w under the conditions of 4℃, 25℃, 37℃and-30℃, were detected using Roche MPX V2.0 kit. The HBV DNA and HIV RNA samples (the concentration was 2-5 times of limit of detection of reagent) were detected by the 6 groups of hemolytic samples (the concentrations of hemoglobin were 97 g/L, 34 g/L,17 g/L, 8 g/L, 5 g/L and 3 g/L, respectively). NAT test was performed at 5-group lipid samples (the concentrations of triglyceride were 7.93 mmol/L, 3.80 mmol/L, 2.63 mmol/L, 1.83 mmol/L and 1.49 mmol/L, respectively) and the control group samples (the concentrations of hemoglobin and triglyceride were 0 g/L and 0.95 mmol/L respectively). Results There were no significant differences in Ct values of HIV RNA or HBV DNA between 4 h to 4 w at 25℃(P>0.05). There were significant differences in Ct values of HBV DNA after preservation for 3 d and 1 w under 37 ℃ compared with those of preservation for 4 h,1 d and 2 d (P<0.005). When Hb concentration was reached to 97 g/L, the results of HBV DNA and HIV RNA were negative. When the concentration of Hb was less than 34 g/L, compared with the control group, there were no significant differences in Ct values of HIV RNA and HBV DNA (P>0.05). When the TG concentration was≤7.93 mmol/L, there were no significant differences in Ct values between the control group and the TG group (P>0.05). Conclusion The samples of HIV RNA and HBV DNA detected by Roche MPX V2.0 kit can be stored at room temperature (25℃) for four weeks. When the concentrations of TG and Hb are less than 7.93 mmol/L and 34 g/L respectively, there are no effects on HIV RNA or HBV DNA samples detected by Roche MPX V2.0 kit.
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STUDY DESIGN: Controlled laboratory study. PURPOSE: This study aimed to evaluate the efficacy of platelet-rich plasma (PRP) stored at room temperature (RT), frozen, or after freeze-drying. OVERVIEW OF LITERATURE: PRP enriches tissue repair and regeneration, and is a novel treatment option for musculoskeletal pathologies. However, whether biological activity is preserved during PRP storage remains uncertain. METHODS: PRP was prepared from blood of 12 healthy human volunteers (200 mL/person) and stored using three methods: PRP was stored at RT with shaking, PRP was frozen and stored at −80℃, or PRP was freeze-dried and stored at RT. Platelet counts and growth factor content were examined immediately after preparation, as well as 2, 4, and 8 weeks after storage. Platelet activation rate was quantified by flow cytometry. RESULTS: Platelet counts were impossible to determine in many RT samples after 2 weeks, but they remained at constant levels in frozen and freeze-dried samples, even after 8 weeks of storage. Flow cytometry showed approximately 80% activation of the platelets regardless of storage conditions. Almost no growth factors were detected in the RT samples after 8 weeks, while low but significant expression was detected in the frozen and freeze-dried PRP. Over time, the mean relative concentrations of various growth factors decreased significantly or disappeared in the RT group. In the frozen group, levels were maintained for 4 weeks, but decreased significantly by 8 weeks (p <0.05). The freeze-dried group maintained baseline levels of growth factors for the entire 8-week duration. CONCLUSIONS: Freeze-drying enables PRP storage while maintaining bioactivity and efficacy for extended periods.
Subject(s)
Humans , Blood Preservation , Flow Cytometry , Freeze Drying , Healthy Volunteers , Intercellular Signaling Peptides and Proteins , Pathology , Platelet Activation , Platelet Count , Platelet-Rich Plasma , RegenerationABSTRACT
BACKGROUND: Because of a lack of substances for platelet (PLT) metabolism and preservation, normal saline (NS) washed PLTs can only be stored for short lengths of time. However, the use of platelet additive solutions (PAS) could help solve this problem. In this study, the in vitro quality of NS washed platelets (wPLTs) stored in two types of PAS were compared with those of wPLTs stored in NS. METHODS: Five units of NS washed apheresis platelets were pooled aseptically and separated into five aliquots for storage in NS only as well as T-PAS+ (Terumo BCT, Lakewood, CO, USA) and CompoSol PS (Fenwal, Lake Zurich, IL, USA) with or without 15 mM glucose. The parameters of wPLTs quality were assessed up to 48 hrs after washing and the whole experiment was repeated 10 times independently. RESULTS: wPLTs in two kinds of PAS had better quality than wPLTs in NS, and wPLTs in T-PAS+ showed better quality than those in CompoSol PS. PAS-stored wPLTs with added glucose maintained stable CD62P and Annexin V expression during storage, but exhibited increased lactate accumulation. Evaluation of in vitro quality revealed that all wPLTs had a rating of 4 immediately after washing. However, only T-PAS+-stored wPLTs with glucose maintained a rating of 4 up to 48 hrs of post-washing. CONCLUSION: Using PAS storage for wPLTs may be beneficial compared to NS. The results presented herein suggest that T-PAS+ containing glucose has the potential to extend storage time by up to 48-hours.
Subject(s)
Annexin A5 , Blood Component Removal , Blood Platelets , Blood Preservation , Glucose , In Vitro Techniques , Lactic Acid , Lakes , MetabolismABSTRACT
Introducción: Los pacientes sometidos a cirugía cardiaca son candidatos a recibir múltiples transfusiones sanguíneas homólogas por causas como el sangrado; el desarrollo de estrategias de conservación sanguínea (ECS) ha permitido proteger al paciente y limitar el riesgo de enfermedades infectocontagiosas, inmunológicas e inflamatorias. Objetivo: Analizar el efecto de las estrategias de conservación sanguínea sobre la transfusión de hemoderivados en los pacientes sometidos a cirugía cardiaca con derivación cardiopulmonar. Material y métodos: Estudio no experimental, exploratorio y transversal. Muestra no probabilística (n = 105) incluyó a pacientes adultos y pediátricos sometidos a cirugía cardiopulmonar con circulación extracorpórea (CEC) que utilizaron las ECS. Recolección de datos con cédula ex profeso de las variables demográficas, hematológicas y transfusionales, CEC, ECS. Datos analizados con frecuencias, porcentajes, medidas de tendencia central y de dispersión; así como prueba de Pearson, U de Mann Whitney y T de Student; significancia p < 0.05. Resultados: Prevalecieron las valvulopatías (42%), cirugías correctivas (98%), tipo de sangre O+. Se recuperaron 120,511 ml de sangre, en promedio 1,161 ml por paciente. Tiempo de CEC relacionado con volumen sangre transfundido (r = 0.318, p = 0.000). Mayor número ECS en la cirugía correctiva (Z = -2.467, p = 0.014), en pacientes con cirugías previas se recupera un mayor volumen (t = 2.072, p = 0.039), cantidad de sangre transfundida durante la CEC es mayor en la bomba centrífuga (t = -4.022, p = 0.000), pero no hay diferencias por sexo (t = 1.488, p = 0.137). La hemoglobina y hematocrito antes y después de la CEC fue semejante (p > 0.05). Conclusiones: Las ECS son una excelente opción de uso para evitar la transfusión homóloga, ya que logran recuperar una gran cantidad de sangre autóloga, potencializándose sus beneficios. (AU)
Background: Patients undergoing cardiac surgery are eligible to receive multiple blood transfusions counterparts for reasons such as bleeding; the development of blood conservation strategies (BCS) has protected the patient and limit the risk of infectious, immunologic and inflammatory diseases. Objective: To analyze the effect of blood conservation strategies on blood transfusion in patients undergoing cardiac surgery with cardiopulmonary bypass. Material and methods: Non-experimental, exploratory and transversal study. Probabilistic sample (n = 105) included adult and pediatric patients undergoing ardiopulmonary surgery with extracorporeal circulation (ECC) using the BCS. Data collection with charter expressly demographic, blood transfusion and variables, ECC, BCS. Data analyzed using frequencies, percentages, measures of central tendency and dispersion; and Pearson test, Mann Whitney and tudent t; significance p < 0.05. Results: A prevalence of valvular heart disease (42%), corrective surgeries (98%), blood type O+. 120,511 ml blood was recovered 1,161 ml per patient. ECC time related to transfused blood volume (r = 0.318, p = 0.000). BCS largest number in corrective surgery (Z = 2467, p = 0.014) in patients with previous surgeries increased volume (t = 2.072, p = 0.039), amount of blood transfused during ECC is recovered is greater in the pump centrifuge (t = 4,022, p = 0.000), but no sex differences (t = 1.488, p = 0.137). Hemoglobin and hematocrit before and after ECC was similar (p > 0.05). Conclusions: The BCS is an excellent choice for use to avoid homologous transfusion, and who manage to recover a large amount of autologous, enhancing its benefits. (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Cardiovascular Diseases , Tri-Ponderal Mass Index , Heart Diseases , Heart Diseases/surgeryABSTRACT
Introdução: O sangue alogênico é um recurso terapêutico esgotável. Novas evidências demonstram um consumo excessivo de sangue e uma diminuição das doações, resultando em estoques de sangue reduzidos em todo o mundo. As transfusões de sangue estão relacionadas a aumento na morbimortalidade e maiores custos hospitalares. Deste modo, torna-se necessário procurar outras opções de tratamento. Estas alternativas existem, porém são pouco conhecidas e raramente utilizadas. Objetivo: Reunir e descrever de maneira sistemática, objetiva e prática todas as estratégias clínicas e cirúrgicas, como opções terapêuticas eficazes para minimizar ou evitar transfusões de sangue alogênico e seus efeitos adversos nos pacientes submetidos à cirurgia cardíaca. Métodos: Foi efetuada uma pesquisa bibliográfica com busca ao descritor “Blood transfusion” (MeSH) e aos termos “Cardiac surgery” e “Blood management”. Estudos com títulos não relacionados diretamente ao tema da pesquisa, estudos que não continham nos resumos dados relacionados à pesquisa, estudos mais antigos que relataram estratégias repetidas foram excluídos. Resultados: Tratar anemia e plaquetopenia, suspender anticoagulantes e antiplaquetários, reduzir flebotomias rotineiras, técnica cirúrgica menos traumática com hipotermia e hipotensão moderada, hemostasia meticulosa, uso de agentes hemostáticos sistêmicos e tópicos, hemodiluição normovolêmica aguda, recuperação sanguínea intraoperatória, tolerância à anemia (oxigênio suplementar e normotermia), bem como várias outras opções terapêuticas mostram ser estratégias eficazes em reduzir transfusões de sangue alogênico. Conclusão: Existem múltiplas estratégias clínicas e cirúrgicas para otimizar a massa eritrocitária e o estado de coagulação, minimizar a perda de sangue e melhorar tolerância à anemia. Estes recursos terapêuticos deveriam ser incorporados à prática médica mundial, visando diminuir o consumo de hemocomponentes, ...
Introdution: 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 ...
Subject(s)
Humans , Blood Transfusion/adverse effects , Cardiac Surgical Procedures/methods , Blood Loss, Surgical/prevention & control , Blood Preservation/methods , Blood Transfusion/methods , Hemostatics/therapeutic use , Medical Illustration , Operative Blood Salvage/methodsABSTRACT
BACKGROUND:Transfusion guidelines pointed out:whole blood should be stored at (4±2)℃. The bacterial growth or loss of function should occur if the blood leaves the suitable storage conditions. Recipients wil suffer from different degrees of blood transfusion reaction or invalid infusion. OBJECTIVE:To observe morphology of erythrocytes of autologous blood stored at different temperatures using microscope. METHODS:Blood was obtained from 40 cases of acute normovolemic hemodilution and stored in ACD citrate bags. Whole blood was respectively stored at 4 ℃ and 23 ℃. Blood smear was taken respectively in the blood storage immediately, 1, 2, 3, 4, 5 and 6 hours after col ecting autologous blood. Changes in morphology of erythrocytes were observed with a microscope. Deformity rate of erythrocytes was calculated. Six blood samples were randomly selected to test pH, K+, and free hemoglobin respectively in 6-hour common temperature group and ACD banked blood within the valid period. Six blood samples were randomly selected for the bacterial culture in each group of two groups at 6 hours. RESULTS AND CONCLUSION:There were no significant differences in abnormality rates of erythrocytes between 4 ℃ and common temperature groups at each time point. The pH, K+, free hemoglobin at six hours in the common temperature group were better than those of ACD banked blood within the valid period and there was no bacterial growth in culture between the two groups. Therefore, it is feasible to transfuse autologous blood back to the patient within 6 hours of storage at room temperature.
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Objective To explore whether storage time and temperature influence the measurement of blood clotting functional parameter,in order to ensure accuracy of result.Methods 60 anticoagulated blood samples were selected.The levels of APTT,PT,TT and FIB were detected immediately after separated plasma,at 1 h,2h,and 4h after keeping at room temperature,at 4h,12h,24h after keeping at-4℃.Part of anticoagulated blood samples were separated plasma and detected 2h after keeping at room temperature.Results Compared to measurement for immediately separated plasma,APTT,PT,TT and FIB showed no differences for 1 h,2h after keeping at room temperature and 4h,12h,24h after keeping at-4℃.But the result for 4h after keeping at room temperature showed bad accuracy.Conclusion In the measurement of coagulation indices,after collecting blood sample,separating plasma should be conducted as soon as possible.The separated plasma should be measured within 2h after keeping at room temperature and 24h after keeping at-4℃.
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BACKGROUND:Blood products and derivatives are indispensable resources in medical therapies. However, it is important to note that the number of donations is far from ideal. Despite constant campaign efforts, a deficit of 1 million units is expected by 2030. OBJECTIVES: To determine the adequacy of the indications for red blood cell transfusion in an emergency hospital in Alagoas. METHODS: This was a cross-sectional observational study conducted at the Alagoas Blood Center. Of a total of 2936 red blood cell transfusion requests in 2009, 334 were randomized and compared with transfusion parameters described in the literature (primary variable). After analysis, the transfusion requests were categorized as adequate, inadequate or inconclusive. This last group included all red blood cell transfusion requests with insufficient clinical information, rendering their classification as adequate or inadequate impossible. The secondary variable involved the reasons for red blood cell transfusion. A 95% confidence interval was used in the statistical analysis. RESULTS: Forty-seven (14.07%) requests were adequate and 30 (8.98%) were inadequate. Most of the requests were classified as inconclusive (76.94%). The main indications for transfusion were upper gastrointestinal bleeding (26.95%), anemia (46.71%), hypovolemia/hypovolemic shock (10.78%) and sepsis/septic shock (3.29%). CONCLUSION: It was not possible to reach a conclusion ...
Subject(s)
Blood Banks , Blood Preservation , Blood Transfusion , Emergency Service, Hospital , Erythrocyte Transfusion , Hospitals, PublicABSTRACT
BACKGROUND: The complete blood count is one of the most common routine tests. This study aimed to evaluate possible effects of the antioxidant taurine on the complete blood count of whole blood stored at room temperature and at 4ºC over seven days. METHODS: Venous blood samples of 25 healthy males were distributed into two sets of tubes with each set of four tubes containing 50 µL of solutions with zero, 2.5 g/L, 5 g/L, 10 g/L taurine. The tubes were kept at room temperature or at 4ºC. Complete blood counts were performed on seven successive days. The mean percentage changes [Δ = (mean value - mean baseline value) / mean baseline value x 100] were calculated and compared. RESULTS: Complete blood count parameters exhibited different patterns of behavior which were affected by the storage temperature, time and taurine concentration. Taurine at room temperature significantly enhancedthe stability of: the platelet count over seven days (Δ7 at 2.5, 5 and 10 g/L taurine were 5.45, 6.11, and 5.80 x 10(9) cells/L, respectively); the red blood cell count over five days (Δ5 at 2.5, 5 and 10 g/L taurine were 1.59, 2.79, and 1.98 x 10(12) cells/L, respectively); mean corpuscular hemoglobin over five days (Δ5 at 2.5, 5 and 10 g/L taurine were -0.91,-1.52 and -0.84 fl respectively); and red cell distribution width over two days (Δ2 at 2.5, 5 and 10 g/L taurine were 0.90%, 1.30% and -0.1%, respectively). No additional stabilizing effects of taurine were reported for the mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, hematocrit and hemoglobin, while it negatively affected the white blood cell stability. CONCLUSION: Complete blood count parameters exhibited variable stability patterns in respect to temperature, time and taurine concentration.
Subject(s)
Humans , Male , Adolescent , Adult , Platelet Count , Taurine , Blood Preservation , Cold Temperature , AntioxidantsABSTRACT
BACKGROUND: Prolonged storage of platelets could improve availability and logistical management and decrease wastage. Immunobiochemical methods can be used to guarantee the quality of platelets after prolonged storage. OBJECTIVE: The aim of this study was to compare storage-related changes in buffy coat-derived platelet concentrations versus platelet-rich plasma. METHODS: Units of whole blood were drawn using a quadruple-bag blood container system. Platelet-rich plasma and buffy coat prepared from whole blood following standard methods were stored for 9 days. During this period test samples were aseptically collected for analysis on Days 1, 2, 3, 5, 7 and 9. RESULTS: The highest CD42b expression was greater than 95%. The percentage of CD62p was significantly lower than the CD42b expression. The pH remained fairly stable during storage. Measurement of pO2 and pCO2 showed that oxygen levels were significantly higher than carbon dioxide levels. There were no significant differences in bicarbonate levels, glucose consumption and lactate production between the groups. The swirling effect with platelet-rich plasma samples decreased after 5 days of storage and after 7 days of storage for buffy coat samples. There was a significant twenty-fold increase in the mean IL-1β after 5 days of storage for both groups. Slight increases in IL-6 and IL-8 levels were seen at 5 days. CONCLUSION: The quality of platelet concentrates remained acceptable during 7 days of storage in respect to the swirling effect, pH and platelet activation. There were no significant differences between buffy coat-derived platelets and platelet-rich plasma in this study.