Transfusion
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After cardiac surgery, red blood cell (RBC) transfusion may improve systemic hemodynamics and thereby microvascular blood flow and O2 delivery (DO2). ⋯ The data argue in favor of efficacy of RBC transfusion after cardiac surgery. RBC transfusion increases systemic Hb and this in turn increases medium-sized vascular density and DO2 in the sublingual microcirculation, independently of systemic hemodynamics and volume status.
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Blood dilution is a frequent complication of massive transfusion during trauma and surgery. This article investigates the quantitative effects of blood plasma dilution on thrombin generation in the context of intersubject variability. ⋯ Dilutional effects on thrombin generation in a human population can be predicted from trends identified for the "average" subject and then refined by performing an analysis of actual subjects in the study group. The MS and PH are dilution indicators that are both sensitive and reliable across a large subject group and could potentially be used as disease markers in the diagnosis of coagulopathic conditions.
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United Arab Emirates (UAE) has a heterogeneous population consisting of more than 160 nationalities and 85% of the population being non-UAE. In 2007, Dubai Blood Donation Centre (DBDC), the major local supplier of blood in the UAE, introduced six-minipool nucleic acid test (NAT) for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV), which in 2008 upgraded to individual-donation (ID)-NAT. The aim of this study was to analyze the efficacy of the donor screening program in the UAE and evaluate the impact of NAT on the yield and residual risk of transfusion-transmissible viral infections (TTVIs). ⋯ Incidence rates and estimated residual risk indicate that the current risk of TTVIs attributable to blood donation is relatively low in the UAE. The study recommends the parallel use of both serology and ID-NAT TTVIs screening in blood donations and suggests the exclusion of antibody to hepatitis B core antigen-positive donations as this can eliminate the potential infectivity of these units with marginal effects on the blood stock in UAE.
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Comparative Study Clinical Trial
Impact of transfusion of autologous 7- versus 42-day-old AS-3 red blood cells on tissue oxygenation and the microcirculation in healthy volunteers.
Stored red blood cells (RBCs) accumulate biochemical and biophysical changes. Maximum storage duration is based on acceptable in vitro characteristics and 24-hour survival, but not RBC function. Relatively little is known about the impact of RBC storage duration on oxygenation and the microcirculation. ⋯ Transfusion of 1 unit of 42-day-stored RBCs to healthy subjects has no overt detrimental effect on tissue oxygenation or the microcirculation assessed by clinically available monitors.