| Effects of red blood cells on hemostasis. | |
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MedLine Citation:
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PMID: 20158685 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Currently there is no sensitive laboratory test to establish the influence of red blood cells (RBCs) on hemostasis. As thromboelastography (TEG) measures hemostasis in whole blood, taking into account the interactions of all cellular elements, we used this instrument to investigate the role that RBCs play in hemostasis. STUDY DESIGN AND METHODS: In 29 patients with chemotherapy-induced anemia we studied the effect of progressive anemia on the coagulation profile. In 24 patients with chronic anemia we studied the effect of transfusion of RBCs on coagulation. Finally, in 18 patients we evaluated whether storage time of RBCs has additional effects on hemostasis. RESULTS: We observed a significant negative correlation between hemoglobin and TEG variables related to both clot strength and elasticity (p < 0.05). Moreover, anemia was associated with a delay in the initiation of the coagulation cascade. Correction of anemia by RBC transfusion resulted in significant shortening of this initiation phase with now the opposite effect on clot strength and elasticity. The negative effects on clot quality were significantly worse when fresh RBCs were transfused compared to longer-stored RBCs. Furthermore, in contrast to the longer-stored RBCs, fresh RBCs did not enhance initial fibrin formation. CONCLUSIONS: In this study we found that anemia was associated with a delay in the initiation of the coagulation cascade with a finally formed clot with superior strength and viscoelastic properties. Transfusion of RBCs was associated with impaired clot quality, with even worse effects on the initial fibrin build-up and clot quality by fresh RBCs. |
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Authors:
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Wilfried W H Roeloffzen; Hanneke C Kluin-Nelemans; Lotte Bosman; Joost Th M de Wolf |
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Publication Detail:
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Type: Journal Article Date: 2010-02-11 |
Journal Detail:
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Title: Transfusion Volume: 50 ISSN: 1537-2995 ISO Abbreviation: Transfusion Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-19 Completed Date: 2010-08-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417360 Medline TA: Transfusion Country: United States |
Other Details:
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Languages: eng Pagination: 1536-44 Citation Subset: IM |
Affiliation:
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Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anemia / blood Blood Platelets / physiology Erythrocyte Transfusion Erythrocytes / physiology* Female Hemoglobins / analysis Hemostasis* Humans Male Middle Aged Thrombelastography |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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