| Exchange Transfusion Therapy and Its Effects on Real-time Microcirculation in Pediatric Sickle Cell Anemia Patients: An Intravital Microscopy Study. | |
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MedLine Citation:
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PMID: 22278200 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Periodic blood exchange transfusion is a treatment modality commonly used to manage pediatric sickle cell anemia at the University of California Davis Medical Center. The goal of exchange transfusion therapy is to ameliorate vasoocclusion and improve tissue perfusion by removing sickled red blood cells and introducing normal red blood cells. Using computer-assisted intravital microscopy, pretransfusion and posttransfusion microvascular characteristics were analyzed. In this study, the bulbar conjunctiva exhibited a "blanched" avascular appearance in all 6 pediatric sickle cell anemia patients before transfusion, indicative of tissue hypoperfusion and ischemia. Immediately after transfusion, substantial improvement in vascularization and tissue perfusion resulted, reflected by the enhanced appearance of capillaries and arterioles. In addition, a decrease in red cell velocity was observed. These observations provide evidence that exchange transfusion therapy is beneficial in ameliorating vasoocclusion and improving tissue perfusion. However, with the paradoxical posttransfusion decrease in red cell velocity presumably due to induced hyperviscosity from the large transfusion volume, blood flow is still impaired. This decreased velocity may thwart efforts to improve oxygen delivery through transfusion and may, to some extent, promote vasoocclusion instead. This paradoxical result warrants further investigation on the effects of transfusion volume and viscosity in the exchange transfusion process. |
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Authors:
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Anthony T W Cheung; Joshua W Miller; Maricel G Miguelino; Wilson J To; Jiajing Li; Xin Lin; Peter C Chen; Sandra L Samarron; Ted Wun; Theodore Zwerdling; Ralph Green |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-23 |
Journal Detail:
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Title: Journal of pediatric hematology/oncology Volume: - ISSN: 1536-3678 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9505928 Medline TA: J Pediatr Hematol Oncol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*Departments of Medical Pathology and Laboratory Medicine †Internal Medicine (Hematology/Oncology) ∥Pediatrics (Hematology/Oncology), University of California Davis School of Medicine ‡Section of Hematology and Oncology, VA Northern California Health Systems, Sacramento §Shiley Center for Orthopedic Research and Education, Scripps Clinic, La Jolla, CA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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