Effects of drying and storage conditions on the stability of TSH in blood spots

ABSTRACT Objective To evaluate the influence of sample drying and storage temperature on TSH stability in neonatal screening. Subjects and methods Blood samples from 29 adult volunteers as a surrogate for neonatal blood (10 with normal TSH, 9 with overt hypothyroid and 10 with subclinical hypothyroidism) were spotted on filter paper and dried at 22°C or 35°C for 3 hours. The samples were then stored at 22°C, -4°C, or -20°C, and TSH measurements were performed at day 0 (D0), D7, D30, D60, D180, and D360 of storage. Results The drying temperature did not interfere with TSH measurement on D0. TSH values remained stable up to D30 when stored at 22°C and were stable up to D60 when stored in a refrigerator or freezer. Samples stored at 22°C had a greater decrease in TSH values than samples stored in a refrigerator or a freezer. Conclusions Freezer storage is not advantageous compared to storage in the refrigerator. At the end of one year, if confirmation of the initial result is required, a reduction of TSH concentrations should be taken into account.

Short-term effects of stored homologous red blood cell transfusion on cardiorespiratory function and inflammation: an experimental study in a hypovolemia model

The pathophysiological mechanisms associated with the effects of red blood cell (RBC) transfusion on cardiopulmonary function and inflammation are unclear. We developed an experimental model of homologous 14-days stored RBC transfusion in hypovolemic swine to evaluate the short-term effects of transfusion on cardiopulmonary system and inflammation. Sixteen healthy male anesthetized swine (68±3.3 kg) were submitted to controlled hemorrhage (25% of blood volume). Two units of non-filtered RBC from each animal were stored under blood bank conditions for 14 days. After 30 min of hypovolemia, the control group (n=8) received an infusion of lactated Ringer's solution (three times the removed volume). The transfusion group (n=8) received two units of homologous 14-days stored RBC and lactated Ringer's solution in a volume that was three times the difference between blood removed and blood transfusion infused. Both groups were followed up for 6 h after resuscitation with collection of hemodynamic and respiratory data. Cytokines and RNA expression were measured in plasma and lung tissue. Stored RBC transfusion significantly increased mixed oxygen venous saturation and arterial oxygen content. Transfusion was not associated with alterations on pulmonary function. Pulmonary concentrations of cytokines were not different between groups. Gene expression for lung cytokines demonstrated a 2-fold increase in mRNA level for inducible nitric oxide synthase and a 0.5-fold decrease in mRNA content for IL-21 in the transfused group. Thus, stored homologous RBC transfusion in a hypovolemia model improved cardiovascular parameters but did not induce significant effects on microcirculation, pulmonary inflammation and respiratory function up to 6 h after transfusion.

Por un programa nacional de colecta y criopreservación de células de sangre de cordón en Cuba / Toward a national program for the collection and criopreservation of cord blood cells in Cuba

Durante los últimos 50 años, el trasplante alogénico de células progenitoras hematopoyéticas (CPH) se convirtió en un tratamiento cada vez más utilizado en la curación de hemopatías malignas y enfermedades no malignas y genéticas, como la drepanocitosis y algunas inmunodeficiencias primarias. Sin embargo, la ausencia de donantes adecuados, por no contar los pacientes con hermanos u otros familiares histocompatibles, ha motivado la búsqueda de fuentes alternativas en donantes no relacionados para garantizar la eficacia y seguridad del trasplante. Una fuente alternativa muy utilizada es la sangre de cordón umbilical (SCU); que ahora se convierte también en una fuente de células para la medicina regenerativa. Los programas de colecta y criopreservación en bancos de SCU (BSCU) se han convertido en una realidad en muchos países dada la importancia de estos tratamientos y debido a sus múltiples ventajas. Sin embargo, estas instalaciones están sujetas a regulaciones nacionales e internacionales, amparadas en estándares y procesos de acreditación. Contar con un programa de colecta y un BSCU público en Cuba es una necesidad para el desarrollo del Sistema Nacional de Salud que resolverá los problemas actuales de carencia de donantes y el intercambio internacional en la lucha por una salud pública mejor(AU)

During the last 50 years, stem cell (SC) allogenic transplant has been an everyday most used form of treatment for the cure of malignant hemopathies and other non-malignant diseases and genetic disorders, such as sickle cell disease and some primary immunodeficiency. Nevertheless, the lack of adequate donors caused by patients without histocompatible brothers or relatives has made it necessary to look for alternatives in non-related donors to guarantee the efficacy and security of transplants. A commonly used source is cord blood (CB); nowadays also known as a source of SC for regenerative medicine. Collection and cryopreservation in CB banks (CBB) have become a reality in many countries due to the importance of these treatments, and to their multiple advantages. Nevertheless, these facilities are subject to national and international regulations, guided by standards and accreditation process. Having a public CBB in Cuba is a need for the development of our National Health System which will allow us to solve the actual donor problem and will allow the international exchange in the struggle for a better public health care(AU)

Opções terapêuticas para minimizar transfusões de sangue alogênico e seus efeitos adversos em cirurgia cardíaca: Revisão sistemática / Therapeutic options to minimize allogeneic blood transfusions and their adverse effects in cardiac surgery: A systematic review

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 ...

Validação in vitro e in vivo da viabilidade de eritrócitos suínos estocados para estabelecer um modelo experimental de transfusão homóloga de hemácias: estudo piloto / In vitro and in vivo validation of stored swine erythrocyte viability to establish an experimental model of homologous red blood cell transfusion: a pilot study

Objetivo: Para desenvolver modelos experimentais de transfusão de hemácias, o primeiro passo é assegurar a viabilidade dos eritrócitos transfundidos. Avaliamos a viabilidade de eritrócitos transfundidos com validação in vitro e in vivo de eritrócitos suínos homólogos armazenados por 14 dias. Métodos: Neste estudo piloto, o sangue coletado de um suíno Agroceres® foi estocado em duas unidades de hemácias. A validação in vivo foi realizada pela marcação dos eritrócitos com Na2 51CrO4 e recuperação dos eritrócitos viáveis após 24 horas da infusão em um animal autólogo e quatro homólogos. A validação in vitro foi realizada na avaliação basal e após 14 dias, pela mensuração da hemoglobina, hematócrito, índice de hemólise e hemoglobina livre em seis unidades de hemácias. Foi realizada uma esplenectomia post-mortem para avaliar o sequestro esplênico de eritrócitos, e a radioatividade das amostras de sobrenadante foi contada para avaliar a hemólise intravascular. Resultados: Após 14 dias de estocagem, as unidades de hemácias tinham volumes menores e concentração total de hemoglobina equivalente em comparação aos padrões humanos. A concentração de hemoglobina livre aumentou de 31,0±9,3 para 112,4±31,4mg/dL (p<0,001) e o índice de hemólise aumentou de 0,1±0,1 para 0,5±0,1% (p<0,001). Entretanto, esses testes se encontravam dentro da faixa aceitável para os padrões humanos. A percentagem de radioatividade nas amostras de sobrenadante foi similar na avaliação basal e após 24 horas, afastando, assim, a presença de hemólise significante. Não se encontraram evidências de sequestro esplênico de eritrócitos radioativos. ...

Objective: To develop experimental models of erythrocyte transfusion, the first step is to ensure the viability of the red blood cells transfused. In this pilot study, we assessed the viability of transfused red blood cells with validation in vitro and in vivo of homologous swine erythrocytes stored for 14 days. Methods: Blood collected from one Agroceres® swine was stored in two red blood cell units. In vivo validation was performed by labeling the red blood cells with Na2 51CrO4 and recovering the viable erythrocytes after 24 hours of infusion in one autologous and four homologous animals. In vitro validation was performed at baseline and after 14 days in sixteen red blood cell units by measuring hemoglobin, hematocrit, hemolysis index and free hemoglobin. A post-mortem splenectomy was performed to evaluate the splenic sequestration of erythrocytes, and the radioactivity of the supernatant samples was counted to evaluate intravascular hemolysis. Results: After 14 days of storage, the red blood cell units had lower volumes and equivalent total concentrations of hemoglobin and hematocrit compared to human standards. The free hemoglobin concentration increased from 31.0±9.3 to 112.4±31.4mg/dL (p<0.001), and the hemolysis index increased from 0.1±0.1 to 0.5±0.1% (p<0.001). However, these tests were within the acceptable range for human standards. The percentage of radioactivity in supernatant samples was similar at baseline and after 24 hours, thus excluding significant hemolysis. No evidence of splenic sequestration of radioactive erythrocytes was found. Conclusion: Swine red blood cells stored for 14 days are viable and can be used in experimental studies of transfusion. These validation experiments are important to aid investigators in establishing experimental models of transfusion. .

La hemovigilancia de las reacciones adversas a la donación de sangre / Hemovigilance of adverse reactions to blood donation

Introducción: en la provincia de Matanzas, de enero del 2003 a diciembre de 2011, se desarrolló un programa de hemovigilancia para incrementar la seguridad de la cadena transfusional. Objetivo: analizar los efectos de este programa sobre las reacciones adversas en los donantes de sangre. Métodos: Se identificó el estado de la notificación de los eventos adversos de la donación en el año 2002, etapa previa al programa. Se mejoró el servicio de donaciones con la revisión de los procederes y las buenas prácticas; a la metodología para la selección del donante se incorporaron los datos geográficos epidemiológicos de cada territorio. A partir de 2003, se notificaron las reacciones adversas de la donación mediante un formulario diseñado para ese fin, se analizaron sus causas, se tomaron las medidas preventivas y correctivas pertinentes. Se efectuaron acciones para prevenir estas y mejorar la calidad de la colecta como capacitación y consejería a los donantes. Se organizó un sistema de alerta rápida para detectar y minimizar los riesgos relacionados con la donación y la calidad de la colecta. Resultados: se disminuyó la tasa de reacciones del donante de 10,1 por mil donaciones en 2002 a 1,4 por mil donaciones en 2011. Se eliminaron las reacciones graves y se minimizaron las moderadas. La reacción más frecuente fue la vasovagal leve. Conclusiones: la hemovigilancia es una herramienta eficaz para incrementar la seguridad de los donantes y mejorar la calidad de la colecta de sangre y puede implementarse con escasos recursos

Introduction: from January 2003 to December 2011 a program of hemovigilance was developed to increase the safety of transfusion in the province of Matanzas. Objective: to analyze the effects of this program on the adverse reactions of blood donors. Methods: adverse reactions to blood donation were identified in 2002 prior to the introduction of the program. The donation service was improved with the revision of procedures and standard practice; epidemiological and geographic data was included in the donor's selection process. From 2003 on, the adverse reactions to donations were notified using a form specially designed; causes were analyzed and prevention and corrective actions were taken. Other proceedings were applied to prevent negative reactions at donation and to improve the quality of blood collection, such as training and advice to donors. A quick alert system was set up to detect and to correct the risks related to donation and the quality of the collection. Results: there was a decrease on the donor's reaction rate from 10, 1 out of 1 000 donations in 2002 to 1,4 out of 1000 in 2011. Severe adverse reactions were eliminated and moderate reactions were minimized. The most frequent was the vasovagal reaction. Conclusions: hemovigilance is an effective tool to increase donors' safety and to improve the quality of blood collection and it can be implemented with scarce resources

Concentrados de plaquetas obtenidos a partir de sangre entera vs por aféresis / Platelet concentrates: random vs apheresis

En la actualidad disponemos de tres tipos de concentrados de plaquetas (CP): CP procesados por el método de plasma rico en plaquetas (CP-PRP) o por el método de capa leucocitaria "buffycoat" (CP-BC) a partir de unidades de sangre entera donadas al azar (CPR) y CP obtenido por aféresis (CP-aféresis). La calidad y caracerísticas de las plaquetas durante el almacenamiento se afectan por una serie de factores, tales como el anticoagulante, la centrifugación y procesamiento después de la colecta, y el agrupamiento antes o después del almacenamiento. Por último, el uso de cada uno de estos componentes ya sean originales, o leucorreducidos, o suspendidos en solución de almacenamiento, o procesados con una técnica de inactivacion de patógenos agrega nuevos factores de complejidad para compararlos. Aunque está claro que el CP-BC retiene mucho más funciones in vitro que el CP-PRP, lo que indica que no se debería utilizar más este último, es mucho más difícil encontrar diferencias con los CP-aféresis. Otro factor que puede afectar la decisión política es la aparición de reacciones adversas en los receptores. Si se consideran solamente los datos comparables, por ejemplo CPR leucorreducida en comparación con CP-aféresis leucorreducida, hay pruebas de que este último está más asociado con reacciones adversas en los receptores. Muy pocos estudios se han publicado comparando la eficacia clínica de los CPR frente a CP-aféresis, considerando como resultado final principalmente el incremento del recuento corregido de plaquetas (IRC). De manera similar a los estudios in vitro, aunque el CP-PRP muestra IRC más bajos, no existe una diferencia clara entre CP-BC y CP-aféresis. Otros aspectos que pueden afectar la decisión es el hecho de que el uso de CP-aféresis en lugar de CPR reduce la exposición total de los pacientes a los donantes, lo cual se considera crítico en algunos países para reducir el riesgo de transmisión de infecciones transmisibles por la sangre...

Testemunhas de jeová ante o uso de hemocomponentes e hemoderivados / Jehovah's Witnesses attitude towards hemocomponents and hemoderivatives

OBJETIVO: Estudar o grau de conhecimento e aceitação de hemocomponentes e hemoderivados, frescos e armazenados, pelas testemunhas de Jeová e propor ferramentas bioéticas para o enfrentamento de eventuais conflitos éticos e morais nas relações com médicos e dentistas. MÉTODOS: Aplicação de questionários a 150 testemunhas de Jeová que frequentam Salões do Reino no Distrito Federal, Brasil. Os questionários buscaram respostas a aspectos sociodemográficos relacionados à possível aceitação de hemocomponentes e hemoderivados pelos pesquisados, bem como a atitude dos profissionais de saúde ante à opção religiosa dos pacientes. RESULTADOS: Dos pesquisados: 74 por cento acreditam que usar sangue provoca mais malefícios do que benefícios à saúde (fundamentação essencialmente bíblica); 96 por cento não aceitam usar hemocomponentes, mas 76 por cento aceitam usar hemoderivados em situações específicas, demonstrando haver entendimentos particulares sobre o tema; 80 por cento se sentem moralmente ofendidos com o uso de sangue armazenado e apenas 45 por cento com sangue fresco, confirmando a interpretação religiosa de que produtos frescos são em geral mais aceitos; segundo 83 por cento dos pesquisados, seus dentistas não perguntaram a religião dos pacientes contra 71 por cento dos médicos, demonstrando pouca preocupação dos profissionais neste aspecto. CONCLUSÃO: As testemunhas de Jeová são vistas por seus "estranhos morais" (aqui, médicos e dentistas) como religiosos que simplesmente "não aceitam sangue". Todavia, diversos tratamentos sanguíneos são hoje aceitos, o que não impede, por livre convicção, a recusa no recebimento de qualquer deles. As interpretações particulares costumam ampliar o rol de proibições e de conflitos morais, já que médicos e dentistas, além de não considerar estas particularidades, também não perguntam a religião na anamnese.

OBJECTIVE: To study extent of knowledge and acceptance of hemocomponents and hemoderivatives, fresh and stored, by Jehovah's Witnesses and also propose bioethical tools for any ethical and moral conflicts identified in their relationship with physicians and dentists. METHODS: A questionnaire was used to interview 150 Jehovah's Witnesses who attend "Salões do Reino" in the Distrito Federal, Brazil. The questionnaire was directed towards information on socio-demographic aspects related to the use (or not ) of hemocomponents and hemoderivatives by those interviewed and also approach of healthcare professionals with patients of this belief. RESULTS: 74 percent believe that the use of blood causes more harm than benefits to health - refusal is essentially based on the Bible 96 percent do not support hemocomponents, but 76 percent support hemoderivatives in specific situations, showing that personal understandings do exist; 80 percent feel morally offended with use of stored blood and only 45 percent with fresh blood, confirming the religious interpretation that fresh products are in general more accepted; according to 83 percent of the interviewees dentists do not ask about patients' religion, whereas 71 percent of physicians do, showing little professional concern about this aspect. CONCLUSION: Jehovah's Witnesses are seen by their "moral outsiders" (here physicians and dentists) as the religious group that simply "does not use blood". Although, several blood treatments are nowadays permitted,. it does not deprive them from a free conviction to refuse blood treatments. Their particular understandings frequently extend the list of blood prohibitions and, consequently, the number of moral conflicts, when considering that physicians and dentists usually do not ask about a patient's religion.

Effect of storage conditions on prothrombin time, activated partial thromboplastin time and fibrinogen concentration on canine plasma samples

The present study was to assess the effect of storage conditions on prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen concentration in blood samples of healthy dogs. Thirty-five dogs of various breeds were included in the study. Citrated blood samples were obtained and plasma was divided into four aliquots to assess selected clotting parameters by means of a coagulometer. The first aliquot was analysed within 1 h after collection, while the remaining 3 were stored at 8degrees C for 4, 8 and 24 h, respectively. One-way repeated measures analysis of variance documented a significant decreasing effect on PT at 24 h compared to 8 h and on fibrinogen concentration after 8 and 24 h compared to sampling time and at 4 and 24 h compared to 8 h post sampling. In conclusion, the results of this study indicate that only fibrinogen appears prone to significant decrease. In fact, aPTT is not substantially affected by refrigeration for at least 24 h post sampling and PT showed a statistical difference that does not necessary indicate biological significance as the results obtained were within reference intervals for the dog.

Stability of the tetramine in blood samples under different temperatures / 法医学杂志

OBJECTIVE@#To study the stability of tetramine in blood samples under different environment temperatures.@*METHODS@#The tetramine samples in 0.5 microg/mL concentration were stored in the environment temperature at 45 degrees C, 25 degrees C and 4 degrees C. The tetramine concentration were measured by GC-MS in 1, 3, 12, 18 and 39 days, respectively. And then the results of measurement were analyzed by SPSS software.@*RESULTS@#At 45 degrees C and 25 degrees C, the concentration of tetramine changed without distinctly in first 3 days and declined significantly from 4 days to 12 days. Thereafter it declined more slowly. At 4 degrees C, the concentration of tetramine changed without distinctly in 12 days and declined significantly from 13 days to 18 days. Thereafter it declined more slowly.@*CONCLUSION@#The concentration of tetra mine in blood samples is stable in 3 days. Thereafter it declined gradually. Temperature also influences the concentration of tetra mine.

Effects of blood storage on ice in biochemical and arterial blood gas analysis of rats / Efeitos da estocagem sanguínea em gelo na bioquímica e gasometria arterial de ratos

PURPOSE: To investigate the effects of blood storage in biochemical and arterial blood gas analysis of Wistar rats. METHODS: Ten adult male rats with weights between 300-350 g were used. The catheterization of the internal carotid artery were performed, followed by withdrawal of 3 ml of blood using 3 separate syringes each containing 1 ml. The syringes were fulfilled one after another and numerated according to the order of collection. Then, the following groups were devised: GT1 - samples that were firstly analyzed in 20 minutes and the second exam 65 minutes after the collection; GT2 - samples that were firstly analyzed in 35 minutes and the second exam 80 minutes after the collection; GT3 - samples that were firstly analyzed in 50 minutes and the second exam 95 minutes after the collection. The samples were stored in a container with a temperature between 0 Cº and 4 Cº. Upon analysis the values of pH, PaCO2, PaO2, HCO3-, SatO2, SBE, Na+ and K+ concentrations and glucose were compared. RESULTS: No statistically relevant difference (p<0.05) between the GT1, GT2 or GT3, when measuring pH, PaCO2, PaO2, HCO3-, SatO2, SBE or glucose, were found. However, Na+ concentration decreased and the K+ concentration increased (p<0.05) when comparing the first analysis (20 minutes) with the last one (95 minutes). CONCLUSION: The blood storage on ice does not interfere in the results of arterial blood gas analysis for the period of at least 95 minutes, except for the Na+ e K+ levels, which are practicable until 80 minutes after storage.

OBJETIVO: Analisar o efeito da estocagem sanguínea na bioquímica e na gasometria do sangue arterial de ratos Wistar. MÉTODOS: Foram utilizados 10 ratos adultos, machos, com peso compreendido entre 300 a 350 gramas. Cada animal foi submetido à cateterização da artéria carótida seguida de heparinização prévia do animal. Foram colhidos 3 ml de sangue total do rato, separados em três seringas contendo 1 ml cada. As seringas foram preenchidas uma após a outra e enumeradas respectivamente à ordem de coleta. De acordo com esta numeração as amostras foram distribuídas nos seguintes grupos: GT1 - amostras que tiveram primeira análise em 20 minutos e a segunda análise 65 minutos após a coleta; GT2 - amostras que tiveram primeira análise em 35 minutos e segunda análise 80 minutos após a coleta; GT3 - amostras que tiveram primeira análise em 50 minutos e 95 minutos após a coleta. As amostras foram estocadas em material isolante térmico, com temperatura entre 0 Cº e 4 Cº. Foram comparados os valores de pH, PaCO2, PaO2, HCO3-, SatO2, SBE, concentrações de Na+ e K+ e glicose. RESULTADOS: Não foram encontradas diferenças estatisticamente significantes (p<0.05) entre GT1, GT2 ou GT3 quando medidos pH, PaCO2, PaO2, HCO3-, SatO2, SBE ou glicose. Entretanto, a concentração de Na+ apresentou decréscimo enquanto que a concentração de K+ aumentou (p<0.05) quando comparados a primeira análise (20 minutos) e a última análise (95 minutos). CONCLUSÃO: A estocagem sanguínea em gelo não interfere nos resultados gasométricos arteriais no período mínimo de 95 minutos, à exceção dos níveis de Na+ e K+, viáveis até 80 minutos de análise pós-estocagem.

Efecto de los leucocitos sobre la lesión por almacenamiento en plaquetas de aferesis / Effect of leukocytes on the storage lesion in apheresis platelet

En el Banco de Sangre , las plaquetas sufren una serie de cambios físicos, metabólicos y fisiológicos que se denominan "lesión por almacenamiento" (LA), que depende de varios factores: métodos de preparación del concentrado, tipo de bolsa utilizada, concentración de plaquetas, número de leucocitos presentes en la unidad y acumulación de citoquinas. Todos ellos podrían producir activación plaquetaria y así afectar la calidad del producto, lo cual se reflejaría en una menor sobrevida de las plaquetas transfundidas. Basándose en lo anterior, se plantea que la remoción precoz de leucocitos aminoraría la LA en los concentrados plaquetarios (CPs) obtenidos por aféresis. Se estudiaron veinte CPs obtenidos mediante dos métodos de aféresis que difieren en el número de leucocitos residuales que permanecen en el producto final; un CP leucoreducido (Cobe Spectra) y otro estándar (Baxter CS 3000 plus). Las determinaciones se realizaron el día cero (prealmacenamiento) y al quinto día de almacenamiento. La evaluación de la LA incluyó marcadores de menbrana plaquetaria: p-selectina (CD62-P), glicoproteína Ib (CD42b), fosfatidilserina (Ax V.), factor tisular (CD142), formación de micropartículas (MPs), los cuales se analizaron por citometría de flujo, y citoquinas liberadas por los leucocitos y/o plaquetas activadas (IL-1. IL-6,FNT y RANTES), las cuales se analizaron por ELISA. El principal marcador de activación de las plaquetas (p-selectina) se encontró significativamente aumentado en los CP leucorreducidos (P: 0.001) y en los obtenidos en forma estándar (p: 0.02). La expresión de GPIb disminuyó significativamente solo en las plaquetas no leucorreducidas (p: 0.01). En relación a la actividad procoagulante de las plaquetas, se observó un aumento significativo en la expresión de fosfatidilserina sobre la cara externa de la membrana (p: 0.019) y de MPs plasmáticas (p: 0.025) solo en las plaquetas leucorreducidas y un muy leve aumento de la expresión de factor tisular...

Under Blood Bank storage conditions, platelet undergo a series of physical, metabolic and physiological changes that are denominated "platelet storage lesion" (PSL). This condition depends on several factors: the platelets number and the methodology used for the preparations of platelet concentrates (PC), type of storage bag, the number of leukocytes present in the cell unit, cytokines release, among others. All these factors may produce platelet activation and thus affect the quality of the product, which would be reflected in a shorter survival of the transfused platelets. Based on the previous knowledge, we hypothesized that early removal of leukocytes from the apheresis concentrate will diminish platelets "activation/lesion" during storage. We studied twenty PC obtained by two methods of apheresis that differed in the number of residual leukoreduced PC (Cobe Spectra) and a standard PC (3000 Baxter CS extra). The determinations were made at day zero (pre-storage) and at the fifth day of storage. The evaluation included markers present in platelets membrane, such as, p-selectin (CD62-P), glycoprotein Ib (CD42b), phosphatydilserine expression (PS). Tissue Factor (CD142) and microparticles (MPs) generation, that were analyzed by flow cytometry. Cytokines released by leucocytes or activated platelet (IL-1). IL-6, TNF and RANTES), were analysed by the ELISA technique. The most important marker of platelets activation, CD62-P, was significantly more increased in leukoreduced CP (P: 0.001) than in the standard method (p: 0.02). The expression of GPIb diminished significantly only in non-leukoreduced platelets (p: 0.01). With regard to the procoagulant activity of platelets, a significant increase in the PS expression was observed on the external face of the platelet membranes (p: 0.019) and on MPs (p: 0.025) only in leukoreduced preparations, changes that were accompanied by a very slight increase of tissue factor expression (p: 0.055). The determinations...