Vox sanguinis
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Identifying factors that can predict adults at high risk of receiving red blood cell transfusion during coronary artery bypass graft (CABG) surgery may aid in more efficient blood banking practices and may tailor blood conservation strategies for these adult patients. The objective was to identify clinical factors associated with increased red cell transfusion in adults undergoing CABG surgery. ⋯ Increasing patient age, female sex, lower preoperative haemoglobin levels, as well as the urgency of the CABG surgery were associated with higher transfusion rates. Identifying risk factors for transfusion may allow for targeted use of blood conservation strategies, improved efficiency in blood utilization and informing adults at risk of transfusion.
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Tissue oxygen delivery depends on red blood cell (RBC) content and RBC flow regulation in the microcirculation. The important role of the RBC in tissue oxygenation is clear from anaemia and the use of RBC transfusion which has saved many lives. Whether RBC transfusion actually restores tissue oxygenation is difficult to determine due to the lack of appropriate clinical monitoring techniques. ⋯ Several intrinsic RBC parameters that change during storage and might influence tissue oxygenation will be mentioned. The release of vasodilators from RBC that will alter blood flow during hypoxia, mediated by haemoglobin in the RBC that functions as an oxygen sensor, could be impaired during storage. A better understanding of hypoxia-induced vasodilator release from RBC might become a potential target for drug development and improve tissue oxygenation after transfusion.
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Reliable blood donor screening requires more accurate measure of haemoglobin (Hb) than by either copper sulphate or the haemoglobin colour scale. The HemoCue haemoglobinometer has established a method for this, but it is considerably more expensive; a modified version (HemoCue 301) has now been developed with a cheaper reagent-free cuvette for use in budget-restricted situations. This report describes evaluation of the performance, the assessment of reproducibility and accuracy of this modified analyser against the reference technique for Hb measurement. ⋯ HemoCue 301 provides a simple and reliable anaemia screen method, conforming to the requirements of CLIA'88 regulations; it is reliable for discriminating Hb values for donor acceptance. The main advantage is that the cuvettes are significantly cheaper than the previous models, and will not deteriorate in adverse climatic conditions.