Transfus Apher Sci
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Comparative Study
Estimation of hemoglobin in blood donors: A comparative study using hemocue and cell counter.
Hemoglobin estimation is an integral part of donor screening in blood banks. Various methods are available for hemoglobin estimation and each one of them has its advantages and limitations. ⋯ We conducted a study involving 535 donors with an aim to assess the accuracy of hemocue readings and compared it with cell counter values. We also compared the hemocue readings using capillary blood with the venous blood.
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We review the experimental evidence showing systemic and microvascular effects of blood transfusions instituted to support the organism in extreme hemodilution and hemorrhagic shock, focusing on the use of fresh vs. stored blood as a variable. The question: "What does a blood transfusion remedy?" was analyzed in experimental models addressing systemic and microvascular effects showing that oxygen delivery is not the only function that must be addressed. ⋯ It is concluded that fresh RBCs are shown to be superior to stored RBCs in transfusion, however increased oxygen affinity may be a positive factor in hemorrhagic shock resuscitation. Although experimental studies seldom reproduce emergency and clinical conditions, nonetheless they serve to explore fundamental physiological mechanisms in the microcirculation that cannot be directly studied in humans.
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Randomized Controlled Trial Multicenter Study
Addressing the question of the effect of RBC storage on clinical outcomes: the Red Cell Storage Duration Study (RECESS) (Section 7).
The question of whether storage of red blood cells (RBCs) alters their capacity to deliver oxygen and affects patient outcomes remains in a state of clinical equipoise. Studies of the changes which occur while RBCs are stored have led to several physiologically plausible hypotheses that these changes impair RBC function when the units are transfused. Although there is some evidence of this effect in vivo from animal model experiments, the results of several largely retrospective patient studies have not been consistent. ⋯ The primary outcome is the change in the Multiple Organ Dysfunction Score (MODS), a composite measure of multiorgan dysfunction, by day 7. Secondary outcomes include the change in the MODS by day 28, all-cause mortality, and several composite and single measures of specific organ system function. The estimated total sample size required will be 1434 evaluable subjects (717 per arm).
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This report describes the evolution of Cord Blood (CB) hematopoietic stem cell transplants (HSCTs) in Europe over time and its current status. There were 687 patients with a first CB HSCT and a total of 763 allogeneic CB HSCT but no autologous CB HSCT reported in the year 2008. The 687 first transplants correspond to 6% of the total 11,408 allogeneic HSCT. ⋯ Main indications for the 639 unrelated first CB HSCT were acute leukaemia (337;53%), non-malignant disorders (115;18%) and lymphoproliferative disorders (53; 8%). 159 teams out of the 368 teams performing allogeneic HSCT (43%) reported 1 to 37 CB HSCT (median 3). There were significant differences in use of CB in the participating European countries with a median CB transplant number of 6.5 (range 1-207), transplant rate (number of CB HSCT/10 million inhabitants) of 6.3 (range 0.1-234.6) and a proportion of CB amongst allogeneic HSCT from 0.7% to 18.2% (median 5.4%). These data document the established role of CB HSCT in Europe but point to significant differences in its use.