[Blood components, special components and whole blood - what and to whom?] / Blodkomponenter och helblod ­ så framställs och används de.

Sweden does not have a national blood authority and guidelines for blood transfusions are lacking, leading to varying routines of production and usage of blood in the different regions. The minimum quality requirements are defined in EU Directive 2002/98/EG and in the Swedish SOSFS 2009:28. The standard blood components are red blood cells, plasma and platelets, while special components such as irradiated, washed, frozen-thawed or antigen-matched products are prescribed on certain clinical indications. Thresholds for transfusion of red blood cells and platelets are discussed as well as indications for plasma transfusions. Further, there is evidence that early, balanced blood transfusions in massive bleeding reduce mortality, which has led to requests for blood products in prehospital settings.

[Introduction of prehospital blood transfusion programme in Sweden: experiences from a physician staffed helicopter emergency medical service]. / Prehospital blodtransfusion är en säker behandling - Erfarenheter från Ambulanshelikoptern i Västra Götalands­regionen.

In 2016, physician staffed helicopter emergency medical service (VGR HEMS) became the first Swedish prehospital service to routinely carry and transfuse red blood cells. In this report we describe our implementation and present our results, with preliminary analysis of our data. Out of 1 336 patients a total of 34 patients (2,5 %) were transfused without any adverse events. Our demography is predominantly male and the most common mechanism of injury is trauma. Amongst the most common interventions were endotracheal intubation, thoracostomy and CPR. Preliminary analysis showed an increase in median systolic blood pressure and decrease in median heart rate after prehospital blood transfusion. Half of the patients that received CPR had return of spontaneous circulation (ROSC). We conclude that prehospital blood transfusion in a Swedish physician-staffed helicopter emergency medical service is feasible and safe.

Exploring the context of the lung proteome within the airway mucosa following allergen challenge.

The lung proteome is a dynamic collection of specialized proteins related to pulmonary function. Many cells of different derivations, activation states, and levels of maturity contribute to the changing environment, which produces the lung proteome. Inflammatory cells reacting to environmental challenge, for example from allergens, produce and secrete proteins which have profound effects on both resident and nonresident cells located in airways, alveoli, and the vascular tree which provides blood cells to the parenchyma alveolar bed for gas exchange. In an experimental model of allergic airway inflammation, we have compared control and allergen challenged lung compartments to determine global protein expression patterns using 2D-gel electrophoresis and subsequent spot identification by MS/MS mass spectrometry. We have then specifically isolated the epithelial mucosal layer, which lines conducting airways, from control and allergen challenged lungs, using laser capture technology and performed proteome identification on these selected cell samples. A central component of our investigations has been to contextually relate the histological features of the dynamic pulmonary environment to the changes in protein expression observed following challenge. Our results provide new information of the complexity of the submucosa/epithelium interface and the mechanisms behind the transformation of airway epithelium from normal steady states to functionally activated states.