Processing of stored packed red blood cells using autotransfusion devices decreases potassium and microaggregates: a prospective, randomized, single-blinded in vitro study
ABSTRACT The aim of the study was to compare the potential of autotransfusion devices to reduce non-infectious complications related to transfusion of long-stored packed red blood cells (PRBC; n= 57), such as changes in electrolytes, blood cells and the load of free microaggregates. Following a baseline measurement, a blood pool of three PRBC was divided into three equal volumes and washed with either the Haemonetics Cell Saver (HCS) or the continuous autotransfusion system (C.A.T.S), using the quality (CATS(quality)) and emergency (CATS(emergency)) mode. After the washing procedure, measurements for electrolytes, blood cells and free microaggregates were repeated (n= 19 each). Compared with baseline, the investigated autotransfusion devices reduced the median load of potassium (baseline: 52 mEq L(-1); HCS: 4 mEq L(-1); CATS(quality): 4 mEq L(-1); CATS(emergency): 17 mEq L(-1); each P < 0.001), restored a physiologic electrolyte balance and significantly decreased the load of leucocytes, glucose and protein. Whereas the quantity of microaggregates was not reduced by HCS, CATS(emergency) decreased the load of cell fragments below 7.8 microm (P < 0.05 vs. baseline). Using CATS(quality) decreased the load of cell fragments not only to a diameter below 7.8 microm (P < 0.001 vs. baseline) but also of microaggregates between 7.8 and 17.6 microm (P < 0.05 vs. baseline). In situations where long-stored PRBC have to be transfused, the procedure described here may be feasible to reduce clinically relevant side effects, i.e. hyperkalaemia and microvascular obstruction secondary to free cell fragments. This approach could be especially useful in patients undergoing massive transfusion and/or suffering from renal failure.
Conference Paper: Dependence of polarimetric Doppler spectra on breaking-wave energy[Show abstract] [Hide abstract]
ABSTRACT: Breaking gravity waves are studied in a wave tank at small grazing angles (4.5°-11°) where all four polarization elements (HH, VV, HV, VH) are simultaneously measured. Temporally averaged Doppler spectra are obtained for mechanically-generated 4 m breaking waves of various energies. The authors describe the dependence on breaking-wave energy of the parameters describing the backscatter. The results of grazing angle dependence of the backscatter are also shown and discussedGeoscience and Remote Sensing Symposium, 1996. IGARSS '96. 'Remote Sensing for a Sustainable Future.', International; 06/1996
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ABSTRACT: The transfusion of red cell (RBC) bags with high amounts of potassium (K(+)) causes concern about an increased risk of cardiac arrest because of transient hyperkalemia. To prevent K(+) overload, a K(+) adsorption filter (PAF) is available for use at bedside. The aim of the present study was to analyze the efficacy in reducing K(+) load in irradiated RBC bags with this PAF. Whole-blood (WB) bags were collected from volunteer donors on Day 0. RBC bags were prepared from WB bags on Day +1 and stored at 2 to 6 degrees C. RBC bags were irradiated on Day +14 and filtered with the PAF on Day +28, according to the manufacturers' instructions. The plasma electrolyte levels (Na(+), K(+), Cl(-), Ca(2+), and Mg(2+)) were measured at the different points during storage. Twelve RBC bags were prepared with a final volume of 274 +/- 15 mL. On Day +28, the volume of RBC bags was 257 +/- 15 mL, and the PAF was used at a flow rate of 4 +/- 0.7 mL per minute. K(+) level after RBC bag preparation was 1.28 +/- 0.59 mmol per L. The K(+) level was 60.6 +/- 2.68 mmol per L on Day +28, just before filtration with the PAF. After filtration, the level of K(+) was 3.42 +/- 2.91 mmol per L. This study has shown a high efficacy in reducing potassium load in irradiated RBC bags with the use of the PAF.Transfusion 07/2008; 48(9):1966-70. DOI:10.1111/j.1537-2995.2008.01776.x · 3.57 Impact Factor
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ABSTRACT: To review the current literature on the role of storage time of transfused red blood cells on microcirculation and tissue oxygenation in critically ill patients. The actual target of transfusion of red blood cells is the maintenance of adequate tissue oxygenation. Recent studies suggest that, besides hemoglobin concentration, mixed or central venous oxygen saturation may also be used as surrogate markers for the estimation of transfusion requirement. However, variables reflecting the concrete target of transfusion, that is tissue oxygenation, appear to be more suitable in this regard. In addition, there is an increasing body of evidence on adverse effects of transfusion of--primarily older--red blood cells on tissue oxygenation and microcirculation. This might be explained, at least in part, by so-called storage lesions, which commence immediately after donation of blood and aggravate over time. Large-scale prospective randomized trials are needed to explicitly clarify the role of new transfusion triggers, such as tissue oxygenation, and the impact of storage lesions of packed red blood cells on tissue oxygenation and--more important--on clinical outcomes in different patient populations.Current opinion in anaesthesiology 05/2009; 22(2):275-80. DOI:10.1097/ACO.0b013e328323f7c4 · 2.53 Impact Factor