Vox sanguinis
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Comparative Study
In vitro comparison of the erythrocyte sedimenting properties of dextran, hydroxyethyl starch and a new low-molecular-weight hydroxyethyl starch.
A low-molecular-weight preparation of hydroxyethyl starch (LMW-HES) may serve as a desirable substitute for the erythrocyte sedimenting agents presently employed to improve neutrophil yields in centrifugation and gravity leukapheresis. The cell-separating and erythrocyte-sedimenting properties of LMW-HES, assessed in vitro by the recovery of various blood cells in plasma supernatant fluids, were similar to those of the higher-molecular-weight hydroxyethyl starch in current use and to dextran under a variety of conditions. These data predict success for LMW-HES as a sedimenting agent in leukapheresis and recommend that it be evaluated in clinical trials.
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This review deals with the rationale for the use of hemodilution in patients not subjected to open heart surgery. The claim for an optimum of circulatory oxygen transport at 30% hematocrit has been disproved; hemodilution thus simply means acute normovolemic anemia. ⋯ Potentially serious clinical side effects have been reported. Hemodilution should therefore not be carried beyong the lower normal range for the hemoglobin or hematocrit level, i.e. 12--12.5 g% or 35--36%.
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(1) Blood was stored in polyvinyl-chloride bags containing citrate-phosphate-dextrose (CPD) with adenine in a final concentration of 0.25 mM. (2) Red cell ATP was well maintained (greater than 70% of original) for 4 weeks in whole blood as well as in red cell concentrate (PCV 85 plus or minus 2%). After 5 weeks the ATP level was about 70% in whole blood and about 40% in red cell concentrate. (3) Red cell 2,3-diphosphoglycerate (DPG) was about 60% of the original after 2 weeks and about 30% after 3 weeks of storage when stored both as whole blood and as red cell concentrate. (4) The red cell 24-hour post-transfusion viability was about 80% after 4 weeks of storage both as whole blood and as red cell concentrate. ⋯ The frequency of transfusion reactions was 3.5% for patients receiving CPD-adenine blood and 4.1% for the control group. (6) The maximum storage time was set at 5 weeks for the CPD-adenine blood and 3 weeks for the ACD blood. The longer preservation time decreased out-dating by at least 50%.