Transfusion
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Artificial oxygen carriers such as perfluorocarbon (PFC) emulsions have reached Phase III clinical trials as alternatives to homologous blood, but their rheologic effects have not been characterized. In this study, the rheologic effects of PFC emulsion in the presence of clinically used volume expanders were investigated. ⋯ It is concluded that this new PFC emulsion increases plasma and blood viscosity and that among the three studied volume expanders, the interaction with MFG can result in viscosity values above the physiologic one even at low Hct values. The possible consequences of the increased viscosity at low Hct values are discussed.
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Red cell (RBC) transfusions are a potentially life-saving therapy employed during the care of many critically ill patients to replace losses in hemoglobin to maintain oxygen delivery to vital organs. During storage, RBCs undergo a series of biochemical and biomechanical changes that reduce their survival and function. Additionally, accumulation of other biologic by-products of RBC preservation may be detrimental to recipients of blood transfusions. ⋯ In this article, the laboratory and animal experiments evaluating changes to RBCs during prolonged storage are reviewed. Subsequently, the clinical studies that have evaluated the clinical consequences of prolonged RBC storage are reviewed. These data suggest a possible detrimental clinical effect associated with the transfusion of stored RBCs; randomized clinical trials further evaluating the clinical consequences of transfusing older stored RBCs are required.
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Comparative Study Clinical Trial
Effects of storage time of red blood cell transfusions on the prognosis of coronary artery bypass graft patients.
In different centers for cardiothoracic surgery throughout the world, different policies are followed concerning the maximum storage time of to-be-transfused red blood cells (RBCs). The aim in this study was to investigate the possible role of the storage time of RBC transfusions on the outcome of coronary artery bypass graft (CABG) surgery patients. ⋯ In these analyses, pertaining to 2732 CABG patients, no justification could be found for use of a particular maximum storage time for RBC transfusions in patients undergoing CABG surgery.
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Comparative Study
Transfusion-related acute lung injury and pulmonary edema in critically ill patients: a retrospective study.
Using the recent Consensus Panel recommendations, we sought to describe the incidence of transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) in critically ill patients. ⋯ In the ICU, pulmonary edema frequently occurs after blood transfusion. The association between infusion of plasma and the development of suspected or possible TRALI may have important implications with regards to etiology and prevention of this syndrome.